AUTUMN D SELF IDPR Registered License verification

Business Entity

ACTIVE

License Type

IDPR Registered

Description

GENETIC COUNSELOR

License Number

246001003

License Status

ACTIVE

Business

First Name

AUTUMN

Middle

Last Name

SELF

Business Name

AUTUMN D SELF

Original Issue Date

06/05/2025

Effective Date

06/05/2025

Expiration Date

01/31/2027

City

MOORESVILLE

State

Zip

28117

Ever Disciplined

LastModifiedDate

06/05/2025