JUSTIN DAVID BLOOMBERG DO - Medical Doctor License in Illinois | # 125065787

JUSTIN DAVID BLOOMBERG DO

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065787

License Status

CANCELLED

Business

N

Title

DO

First Name

JUSTIN

Middle

DAVID

Last Name

BLOOMBERG

Business Name

JUSTIN DAVID BLOOMBERG DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2017

State

IL

Specialty/Qualifier

Ophthalmology

Ever Disciplined

N

LastModifiedDate

05/28/2015