**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**
1.
Do you possess a current license as Dietitian/Nutritionist from the Maryland Board of Dietetic Practice?
Yes
No
2.
If yes, please provide your license type, license number and expiration date below.