DAVID ALAN BLOOM DDS - Dentist License in Illinois | # 019014800

DAVID ALAN BLOOM DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014800

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005