DIANE FORMOSO - Registered Nurse License in Indiana | # 041204819

DIANE FORMOSO

Business Entity

ACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041204819

License Status

ACTIVE

Business

N

First Name

DIANE

Last Name

FORMOSO

Business Name

DIANE FORMOSO

Original Issue Date

10/08/1981

Effective Date

05/24/2024

Expiration Date

05/31/2026

State

IN

Ever Disciplined

N

LastModifiedDate

02/28/2026