SAMANTHA J VANDER BLOOMEN - Dietitian and Nutritionist License in Wisconsin | # 164006887

SAMANTHA J VANDER BLOOMEN

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164006887

License Status

NOT RENEWED

Business

N

First Name

SAMANTHA

Middle

J

Last Name

VANDER BLOOMEN

Business Name

SAMANTHA J VANDER BLOOMEN

Original Issue Date

08/03/2016

Effective Date

01/19/2022

Expiration Date

10/31/2023

State

WI

Ever Disciplined

N

LastModifiedDate

04/02/2026