SPENCER ROBERT BLOOM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

NOT RENEWED

Business

First Name

SPENCER ROBERT

Last Name

BLOOM

Suffix

DDS

Business Name

SPENCER ROBERT BLOOM DDS

Original Issue Date

01/01/1998

Effective Date

09/07/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60641

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022