JOHN DOUGLAS BLOOM DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

ACTIVE

Business

First Name

JOHN DOUGLAS

Last Name

BLOOM

Suffix

DDS

Business Name

JOHN DOUGLAS BLOOM DDS

Original Issue Date

07/28/2009

Effective Date

05/23/2024

Expiration Date

09/30/2027

City

CRYSTAL LAKE

State

Zip

60012

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/23/2024