DAVID ALAN BLOOM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014800

License Status

NOT RENEWED

Business

First Name

DAVID ALAN

Last Name

BLOOM

Suffix

DDS

Business Name

DAVID ALAN BLOOM DDS

Original Issue Date

07/17/1974

Effective Date

07/17/1974

City

FOREST PARK

State

Zip

60130

County

COOK

Ever Disciplined

LastModifiedDate

10/12/2005