DEREK J X WAGNER
Dietitian and Nutritionist at Broadway, Providence, RI

License number
Rhode Island FMC09750
Issued Date
Jan 18, 2002
Expiration Date
Jan 18, 2020
Category
Food Safety
Type
Certified Food Safety Mgr
Address
Address
500 Broadway, Providence, RI 02903
Phone
(401) 421-0286 (Work)
LicenseFiles verified this license of Apr 7, 2017 at the Rhode Island Department of Health.

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