SCOTT DOUGLAS BLANK Dietitian and Nutritionist License verification

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164003920

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

DOUGLAS

Last Name

BLANK

Business Name

SCOTT DOUGLAS BLANK

Original Issue Date

06/04/2003

Effective Date

10/25/2017

Expiration Date

10/31/2019

City

GALESBURG

State

Zip

61401

County

KNOX

Ever Disciplined

LastModifiedDate

01/23/2020