AMELIA A PROVOST Dietitian and Nutritionist License verification

Business Entity

ACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164008313

License Status

ACTIVE

Business

First Name

AMELIA

Middle

Last Name

PROVOST

Business Name

AMELIA A PROVOST

Original Issue Date

03/05/2021

Effective Date

10/22/2025

Expiration Date

10/31/2027

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

10/22/2025