KENNETH J BLOOM MD - Medical Doctor License in Illinois | # 125017598

KENNETH J BLOOM MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017598

License Status

EXPIRED

Business

N

First Name

KENNETH J

Last Name

BLOOM

Suffix

MD

Business Name

KENNETH J BLOOM MD

Original Issue Date

07/25/1984

Effective Date

07/25/1984

Expiration Date

06/25/1986

State

IL

Specialty/Qualifier

Pathology

Ever Disciplined

N

LastModifiedDate

09/22/2006