The holder whose full name is BLACK, ANNIE STANLEY,come from Bloomington IN,hold the Registered Nurse license(NO.28020141A) which status is Expired.
| Name | BLACK, ANNIE STANLEY |
|---|---|
| License Number | 28020141A |
| License Type | Registered Nurse |
| License Status | Expired |
| City | Bloomington |
| State | IN |