CARL D BLOOM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000382

License Status

NOT RENEWED

Business

First Name

CARL D

Last Name

BLOOM

Business Name

CARL D BLOOM

Original Issue Date

07/12/1989

Effective Date

07/12/1989

Expiration Date

06/30/1990

City

CHCAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Advanced General Dentistry

Ever Disciplined

LastModifiedDate

10/12/2005