THEA J CROCKETT Dietitian and Nutritionist License verification

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164001127

License Status

NOT RENEWED

Business

First Name

THEA

Middle

Last Name

CROCKETT

Business Name

THEA J CROCKETT

Original Issue Date

12/06/1995

Effective Date

10/22/2013

Expiration Date

10/31/2015

City

HAZEL CREST

State

Zip

60429

County

COOK

Ever Disciplined

LastModifiedDate

12/09/2015