MARY KRYSTOFIAK RUSSELL Dietitian and Nutritionist License verification

Business Entity

INACTIVE

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164004471

License Status

INACTIVE

Business

First Name

MARY

Middle

KRYSTOFIAK

Last Name

RUSSELL

Business Name

MARY KRYSTOFIAK RUSSELL

Original Issue Date

03/02/2006

Effective Date

11/02/2021

Expiration Date

10/31/2023

City

MIDDLETON

State

Zip

53562

Ever Disciplined

LastModifiedDate

10/31/2023