KENNETH J BLOOM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036073279

License Status

ACTIVE

Business

First Name

KENNETH J

Last Name

BLOOM

Suffix

Business Name

KENNETH J BLOOM MD

Original Issue Date

07/24/1986

Effective Date

05/20/2023

Expiration Date

07/31/2026

City

SAN CLEMENTE

State

Zip

92673

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

05/20/2023