CARL D BLOOM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019021720

License Status

NOT RENEWED

Business

First Name

CARL D

Last Name

BLOOM

Business Name

CARL D BLOOM

Original Issue Date

09/02/1989

Effective Date

09/02/1989

Expiration Date

09/30/2000

City

GULFPORT

State

Zip

39507

County

MISSISSIPPI

Ever Disciplined

LastModifiedDate

10/17/2005