RICHARD ALAN BLOOM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036047304

License Status

INACTIVE

Business

First Name

RICHARD ALAN

Last Name

BLOOM

Suffix

Business Name

RICHARD ALAN BLOOM MD

Original Issue Date

04/23/1973

Effective Date

04/21/2011

Expiration Date

07/31/2014

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Ever Disciplined

LastModifiedDate

04/08/2014