ANDREW BLOOM DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****40

License Status

ACTIVE

Business

Title

DDS

First Name

ANDREW

Last Name

BLOOM

Business Name

ANDREW BLOOM DDS

Original Issue Date

06/25/2024

Effective Date

06/25/2024

Expiration Date

09/30/2027

City

INDIANAPOLIS

State

Zip

46203

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/25/2024