KEELY NICOLE BOURASSA Dietitian and Nutritionist License verification

Business Entity

ACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164022480

License Status

ACTIVE

Business

First Name

KEELY

Middle

NICOLE

Last Name

BOURASSA

Business Name

KEELY NICOLE BOURASSA

Original Issue Date

07/16/2025

Effective Date

11/01/2025

Expiration Date

10/31/2027

City

TERRE HAUTE

State

Zip

47802

Ever Disciplined

LastModifiedDate

10/14/2025