ALLEN D BLOOM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125014606

License Status

EXPIRED

Business

First Name

ALLEN D

Last Name

BLOOM

Suffix

Business Name

ALLEN D BLOOM MD

Original Issue Date

06/30/1982

Effective Date

06/30/1982

Expiration Date

06/28/1984

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006