STEPHANIE LEE WAGNER Dietitian and Nutritionist License verification

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164006890

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

LEE

Last Name

WAGNER

Business Name

STEPHANIE LEE WAGNER

Original Issue Date

08/04/2016

Effective Date

10/22/2019

Expiration Date

02/28/2022

City

BELVIDERE

State

Zip

61008

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/27/2022