DONNA M HOMUTH Dietitian and Nutritionist License verification

Business Entity

CANCELLED

License Type

Dietitian and Nutritionist

Description

LICENSED NUTRITION COUNSELOR

License Number

165000282

License Status

CANCELLED

Business

First Name

DONNA

Middle

Last Name

HOMUTH

Business Name

DONNA M HOMUTH

Original Issue Date

09/29/2004

Effective Date

09/29/2004

Expiration Date

10/31/2005

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/29/2005