LACIE DIANE BAGWELL Dietitian and Nutritionist License verification

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164004504

License Status

NOT RENEWED

Business

First Name

LACIE

Middle

DIANE

Last Name

BAGWELL

Business Name

LACIE DIANE BAGWELL

Original Issue Date

04/17/2006

Effective Date

11/02/2017

Expiration Date

10/31/2019

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Ever Disciplined

LastModifiedDate

01/23/2020