PENNY E BOLEN Dietitian and Nutritionist License verification

Business Entity

ACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164001351

License Status

ACTIVE

Business

First Name

PENNY E

Last Name

BOLEN

Business Name

PENNY E BOLEN

Original Issue Date

12/16/1995

Effective Date

10/22/2025

Expiration Date

10/31/2027

City

ROCKFORD

State

Zip

61109

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

10/22/2025