Indiana
State Board of Nursing
CONSTANCE Y FORMSMA
Licensed Practical Nurse
License number
27013283A
Date granted
01/01/1974
Date expires
12/31/1986
Class
Licensed Practical Nurse
Status
Expired
Address
ELKHART IN 46514
nursingindiana.org
ID 6473203
LAST UPDATED 2024-03-27 15:11:38 UTC
LAST UPDATED 2024-03-27 15:11:38 UTC
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