JUSTIN DAVID BLOOMBERG DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036143832

License Status

NOT RENEWED

Business

Title

First Name

JUSTIN

Middle

DAVID

Last Name

BLOOMBERG

Business Name

JUSTIN DAVID BLOOMBERG DO

Original Issue Date

07/13/2017

Effective Date

07/13/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021