Exhibit
4.6


 


THIS FIRST SUPPLEMENTAL
INDENTURE, dated as of August 20, 2004 (this “First Supplemental
Indenture”), is by and among US Oncology, Inc., a Delaware corporation (“US
Oncology”), each of the parties identified as a Subsidiary Guarantor on the
signature pages hereto (each, a “Subsidiary Guarantor” and collectively,
the “Subsidiary Guarantors”) and LaSalle Bank National Association, a
national banking association, as trustee (the “Trustee”).


 


WITNESSETH


 


WHEREAS, Oiler
Acquisition Corp. (the “Company”) and the Trustee are parties to an
indenture dated as of August 20, 2004 (the “ Indenture”), providing
for the issuance of the Company’s 9% Senior Notes due 2012 (the “Securities”);


 


WHEREAS, the Company has
merged with and into US Oncology (the “Merger”);


 


WHEREAS, pursuant to Section 5.01
of the Indenture, US Oncology is assuming, by and under this First Supplemental
Indenture, the Company’s obligations for the due and punctual payment of the
principal of, premium, if any, and interest on all the Securities and the
performance and observance of each covenant of the Indenture on the part of the
Company to be performed or observed;


 


WHEREAS, pursuant to Section 11.06
of the Indenture, each Subsidiary Guarantor is unconditionally and irrevocably
guaranteeing US Oncology’s obligations with respect to the Securities on the
terms set forth in the Indenture; and


 


WHEREAS, pursuant to Section 9.01
of the Indenture, the Trustee is authorized to execute and deliver this First
Supplemental Indenture.


 


NOW, THEREFORE, for and
in consideration of the foregoing premises, it is mutually covenanted and
agreed, for the equal and proportionate benefit of all Holders of the
Securities, as follows:


 


1.                                       Capitalized
Terms. Capitalized terms used herein without definition shall have the
meanings assigned to them in the Indenture.


 


2.                                       Assumption
by US Oncology. US Oncology hereby assumes the Company’s obligations for
the due and punctual payment of the principal of, premium, if any, and interest
on all outstanding Securities issued pursuant to the Indenture and the
performance and observance of each other obligation and covenant set forth in
the Indenture to be performed or observed on the part of the Company. US
Oncology is hereby substituted for, and may exercise every right and power of,
the Company under the Indenture with the same effect as if US Oncology had been
named as the Company in the Indenture.


 


3.                                       Notation
on Securities. Securities authenticated and delivered after the date hereof
may bear the following notation, which may be stamped or imprinted thereon:


 





















 


“In
connection with the merger of Oiler Acquisition Corp. (the “Company”)
with and into US Oncology, Inc. (“US Oncology”) and pursuant to the
First Supplemental Indenture dated as of August 20, 2004, US Oncology has
assumed the Company’s obligations for the due and punctual payment of the
principal of, premium, if any, and interest on this Security and the
performance of each other obligation and covenant set forth in the Indenture to
be performed or observed on the part of the Company.”


 


4.                                       Agreements
to Become Guarantors. Each of the Subsidiary Guarantors hereby
unconditionally and irrevocably guarantees US Oncology’s obligations under the Securities
and the Indenture on the terms and subject to the conditions set forth in Article XI
of the Indenture and agree to be bound by all other provisions of the Indenture
and the Securities applicable to a Subsidiary Guarantor therein.


 


5.                                       Ratification
of Indenture: First Supplemental Indenture Part of Indenture. Except as expressly
amended hereby, the Indenture is in all respects ratified and confirmed and all
the terms, conditions and provisions thereof shall remain in full force and
effect. This First Supplemental Indenture shall form a part of the Indenture
for all purposes, and every Holder of Securities heretofore or hereafter
authenticated and delivered shall be bound hereby.


 


6.                                       Notices.
For purposes of Section 13.02 of the Indenture, the address for notices to
US Oncology and each of the Subsidiary Guarantors shall be:


 


c/o US Oncology, Inc.

16825 Northchase Drive

Suite 1300

Houston, Texas 77060

Attention: General Counsel


 


7.                                       Governing
Law. This First Supplemental Indenture shall be governed by, and construed
in accordance with, the laws of the State of New York.


 


8.                                       Counterparts.
The parties may sign any number of copies of this First Supplemental Indenture.
Each signed copy shall be an original, but all of them together shall represent
the same agreement.


 


9.                                       Effect
of Headings. The section headings herein are for convenience only and
shall not affect the construction hereof.


 


10.                                 The
Trustee. The Trustee shall not be responsible in any manner whatsoever for
or in respect of the validity or sufficiency of this First Supplemental
Indenture or for or in respect of the recitals contained herein, all of which
recitals are made solely by US Oncology and the Subsidiary Guarantors.


 





















 


IN WITNESS WHEREOF, the
parties hereto have caused this First Supplemental Indenture to be duly
executed, all as of the date first above written.


 


	
   

  	
  US ONCOLOGY, INC.

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Chief Financial Officer

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  ALABAMA PHARMACEUTICAL
  SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  AOR HOLDING COMPANY OF
  INDIANA, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  



 





















 


	
   

  	
  AOR MANAGEMENT COMPANY
  OF ARIZONA, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  AOR MANAGEMENT COMPANY
  OF INDIANA, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  AOR MANAGEMENT COMPANY
  OF MISSOURI, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  AOR MANAGEMENT COMPANY
  OF OKLAHOMA, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  



 





















 


	
   

  	
  AOR MANAGEMENT COMPANY
  OF PENNSYLVANIA, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  AOR MANAGEMENT COMPANY
  OF TEXAS, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  AOR MANAGEMENT COMPANY
  OF VIRGINIA, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  AOR REAL ESTATE, INC.,
  as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  



 





















 


	
   

  	
  AOR OF INDIANA
  MANAGEMENT PARTNERSHIP, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  AOR MANAGEMENT COMPANY
  OF INDIANA, INC.

  
	
   

  	
  Its:

  	
  General Partner

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  
	
   

  	
  Name:

  	
  Bruce Broussard

  
	
   

  	
  Title:

  	
  Vice President

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  and

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  AOR HOLDING COMPANY OF INDIANA,
  INC.

  
	
   

  	
  Its:

  	
  General Partner

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  
	
   

  	
  Name:

  	
  Bruce Broussard

  
	
   

  	
  Title:

  	
  Vice President

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  AOR OF TEXAS MANAGEMENT
  LIMITED PARTNERSHIP, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  AOR MANAGEMENT COMPANY
  OF TEXAS, INC.

  
	
   

  	
  Its:

  	
  General Partner

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  
	
   

  	
  Name:

  	
  Bruce Broussard

  
	
   

  	
  Title:

  	
  Vice President

  
				



 





















 


	
   

  	
  AOR SYNTHETIC REAL
  ESTATE, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  AORT HOLDING COMPANY,
  INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  CALIFORNIA
  PHARMACEUTICAL SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  FLORIDA PHARMACEUTICAL
  SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  



 





















	
   

  	
  GREENVILLE RADIATION
  CARE, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  IOWA PHARMACEUTICAL
  SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  MICHIGAN PHARMACEUTICAL
  SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  NEBRASKA PHARMACEUTICAL
  SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  



 





















 


	
   

  	
  NEW MEXICO
  PHARMACEUTICAL SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  NORTH CAROLINA
  PHARMACEUTICAL SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  PENNSYLVANIA
  PHARMACEUTICAL SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  PHYSICIAN RELIANCE
  HOLDINGS, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  



 





















 


	
   

  	
  PHYSICIAN RELIANCE
  NETWORK, INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  RMCC CANCER CENTER,
  INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  SELECTPLUS ONCOLOGY,
  LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  ST. LOUIS
  PHARMACEUTICAL SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  



 





















 


	
   

  	
  TEXAS PHARMACEUTICAL
  SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  TOPS PHARMACY SERVICES,
  INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  US ONCOLOGY CORPORATE,
  INC., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  US ONCOLOGY
  PHARMACEUTICAL SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  



 





















 


	
   

  	
  US ONCOLOGY RESEARCH,
  INC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Vice President

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  WASHINGTON
  PHARMACEUTICAL SERVICES, LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  	
   

  
	
   

  	
  Name:

  	
  Bruce Broussard

  	
   

  
	
   

  	
  Title:

  	
  Manager

  	
   

  



 





















 


	
   

  	
  PHYSICIAN RELIANCE,
  L.P., as a Subsidiary Guarantor

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  PRN Physician Reliance,
  LLC

  
	
   

  	
  Its:

  	
  General Partner

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  
	
   

  	
  Name:

  	
  Bruce Broussard

  
	
   

  	
  Title:

  	
  Manager

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  PRN PHYSICIAN RELIANCE,
  LLC, as a Subsidiary Guarantor

  
	
   

  	
   

  
	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Bruce Broussard

  
	
   

  	
  Name:

  	
  Bruce Broussard

  
	
   

  	
  Title:

  	
  Manager

  
				



 





















 


	
   

  	
  LASALLE BANK NATIONAL
  ASSOCIATION, as Trustee

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
  By:

  	
  /s/ Vernita L Anderson

  	
   

  
	
   

  	
  Name:

  	
  VERNITA L ANDERSON

  	
   

  
	
   

  	
  Title:

  	
  Assistant Vice
  President