BLAINE DEREK HARBOURNE Dietitian and Nutritionist License verification

Business Entity

ACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164007341

License Status

ACTIVE

Business

First Name

BLAINE

Middle

DEREK

Last Name

HARBOURNE

Business Name

BLAINE DEREK HARBOURNE

Original Issue Date

02/21/2018

Effective Date

08/05/2025

Expiration Date

10/31/2027

City

GLEN ELLYN

State

Zip

60137

Ever Disciplined

LastModifiedDate

08/05/2025