GLORIA J SAMPLE Dietitian and Nutritionist License verification

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164004182

License Status

NOT RENEWED

Business

First Name

GLORIA

Middle

Last Name

SAMPLE

Business Name

GLORIA J SAMPLE

Original Issue Date

08/24/2004

Effective Date

10/28/2013

Expiration Date

10/31/2015

City

OSWEGO

State

Zip

60543

County

KENDALL

Ever Disciplined

LastModifiedDate

12/09/2015