KIM R HANSON

Business Entity
ACTIVE

Registered Nurse

LICENSED PRACTICAL NURSE

043055663

ACTIVE

N

KIM

R

HANSON

KIM R HANSON

02/23/1983

11/09/2024

01/31/2027

GARY

IN

46409

LAKE

Y

11/09/2024

1991003073

Fine

05/15/1992

Submitted non-bankable payment to the Department.