BRUCE E BLOOM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

First Name

BRUCE E

Last Name

BLOOM

Suffix

DDS

Business Name

BRUCE E BLOOM DDS

Original Issue Date

07/31/1981

Effective Date

07/31/1981

Expiration Date

09/30/1996

City

DEERFIELD

State

Zip

60015

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005