RICHARD ALAN BLOOM MD - Medical Doctor License in Illinois | # 036047304

RICHARD ALAN BLOOM MD

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047304

License Status

INACTIVE

Business

N

First Name

RICHARD ALAN

Last Name

BLOOM

Suffix

MD

Business Name

RICHARD ALAN BLOOM MD

Original Issue Date

04/23/1973

Effective Date

04/21/2011

Expiration Date

07/31/2014

State

IL

Ever Disciplined

N

LastModifiedDate

04/08/2014