EXCELSA A BASUEL Dietitian and Nutritionist License verification

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164002095

License Status

NOT RENEWED

Business

First Name

EXCELSA A

Last Name

BASUEL

Business Name

EXCELSA A BASUEL

Original Issue Date

01/18/1996

Effective Date

10/10/2003

Expiration Date

10/31/2005

City

HIGHLAND

State

Zip

62249

County

MADISON

Ever Disciplined

LastModifiedDate

12/22/2005