SUSAN JEAN BASALA - Dietitian and Nutritionist License in Illinois | # 164002594

SUSAN JEAN BASALA

Business Entity

INACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164002594

License Status

INACTIVE

Business

N

First Name

SUSAN JEAN

Last Name

BASALA

Business Name

SUSAN JEAN BASALA

Original Issue Date

04/24/1996

Expiration Date

10/31/1997

State

IL

Ever Disciplined

N

LastModifiedDate

07/28/2005