JEFFREY N BLOOM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079043

License Status

NOT RENEWED

Business

First Name

JEFFREY N

Last Name

BLOOM

Suffix

Business Name

JEFFREY N BLOOM MD

Original Issue Date

06/20/1989

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008