CARL D BLOOM Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

CANCELLED

Business

First Name

CARL D

Last Name

BLOOM

Business Name

CARL D BLOOM

Original Issue Date

08/22/1990

Effective Date

08/22/1990

Expiration Date

09/30/1992

City

HOUSTON

State

Zip

77096

County

TEXAS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005