PHILIP ROBERT LARSON Dietitian and Nutritionist License verification

Business Entity

ACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164011434

License Status

ACTIVE

Business

First Name

PHILIP

Middle

ROBERT

Last Name

LARSON

Business Name

PHILIP ROBERT LARSON

Original Issue Date

11/30/2024

Effective Date

10/22/2025

Expiration Date

10/31/2027

City

TAHLEQUAH

State

Zip

74464

Ever Disciplined

LastModifiedDate

02/26/2026