TERI E FORDYCE Dietitian and Nutritionist License verification

Business Entity

INACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164001916

License Status

INACTIVE

Business

First Name

TERI E

Last Name

FORDYCE

Business Name

TERI E FORDYCE

Original Issue Date

01/16/1996

Effective Date

05/22/2004

Expiration Date

10/31/2005

City

DUNLAP

State

Zip

61525

County

PEORIA

Ever Disciplined

LastModifiedDate

09/09/2005