The holder whose full name is Black, Carol Ann,come from Rensselaer IN,hold the Registered Nurse license(NO.28178808A) which status is Active.
| Name | Black, Carol Ann |
|---|---|
| License Number | 28178808A |
| License Type | Registered Nurse |
| License Status | Active |
| City | Rensselaer |
| State | IN |