CARLY DYANN GUSTAFSON Dietitian and Nutritionist License verification

Business Entity

INACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164004154

License Status

INACTIVE

Business

First Name

CARLY

Middle

DYANN

Last Name

GUSTAFSON

Business Name

CARLY DYANN GUSTAFSON

Original Issue Date

07/30/2004

Effective Date

08/17/2009

Expiration Date

10/31/2011

City

OAK CREEK

State

Zip

53154

County

WISCONSIN

Ever Disciplined

LastModifiedDate

08/03/2011