MICAH JAYNE HENDERSON Dietitian and Nutritionist License verification

Business Entity

ACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164010351

License Status

ACTIVE

Business

First Name

MICAH

Middle

JAYNE

Last Name

HENDERSON

Business Name

MICAH JAYNE HENDERSON

Original Issue Date

06/18/2024

Effective Date

09/25/2025

Expiration Date

10/31/2027

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/25/2025