SAMANTHA J VANDER BLOOMEN Dietitian and Nutritionist License verification

Business Entity

NOT RENEWED

License Type

Dietitian and Nutritionist

Description

LICENSED DIETITIAN NUTRITIONIST

License Number

164006887

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

Last Name

VANDER BLOOMEN

Business Name

SAMANTHA J VANDER BLOOMEN

Original Issue Date

08/03/2016

Effective Date

01/19/2022

Expiration Date

10/31/2023

City

RACINE

State

Zip

53403

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/08/2025