SUELLA H HEACOCK Dietitian and Nutritionist License verification

Business Entity

INACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164000635

License Status

INACTIVE

Business

First Name

SUELLA

Middle

Last Name

HEACOCK

Business Name

SUELLA H HEACOCK

Original Issue Date

10/24/1995

Effective Date

08/03/2017

Expiration Date

10/31/2019

City

PLEASANT PLAINS

State

Zip

62677

County

SANGAMON

Ever Disciplined

LastModifiedDate

08/03/2019