STACI RENEE COUSSENS Dietitian and Nutritionist License verification

Business Entity

ACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164008255

License Status

ACTIVE

Business

First Name

STACI

Middle

RENEE

Last Name

COUSSENS

Business Name

STACI RENEE COUSSENS

Original Issue Date

01/11/2021

Effective Date

10/30/2025

Expiration Date

10/31/2027

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

10/30/2025