PATAMA SUKSURAS Dietitian and Nutritionist License verification

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164006014

License Status

NOT RENEWED

Business

First Name

PATAMA

Last Name

SUKSURAS

Business Name

PATAMA SUKSURAS

Original Issue Date

09/25/2013

Effective Date

08/07/2019

Expiration Date

02/28/2022

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/27/2022