JOHN BLOOM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****40

License Status

NOT RENEWED

Business

First Name

JOHN

Last Name

BLOOM

Business Name

JOHN BLOOM

Original Issue Date

03/04/2019

Effective Date

03/04/2019

Expiration Date

01/31/2022

City

SCHAUMBURG

State

Zip

60194

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022