DONNA H MATHIS Dietitian and Nutritionist License verification

Business Entity

CANCELLED

License Type

Dietitian and Nutritionist

Description

LICENSED NUTRITION COUNSELOR

License Number

165000123

License Status

CANCELLED

Business

First Name

DONNA

Middle

Last Name

MATHIS

Business Name

DONNA H MATHIS

Original Issue Date

02/21/1996

Effective Date

12/10/2003

Expiration Date

10/31/2003

City

GRANTSBURG

State

Zip

62943

County

JOHNSON

Ever Disciplined

LastModifiedDate

07/29/2005