SUSAN J BLOOM Advanced Practice Nurse License verification

Business Entity

NOT RENEWED

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****74

License Status

NOT RENEWED

Business

First Name

SUSAN

Middle

Last Name

BLOOM

Business Name

SUSAN J BLOOM

Original Issue Date

03/31/2009

Effective Date

05/25/2010

Expiration Date

05/31/2012

City

WESTMONT

State

Zip

60559

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/10/2012