KURT BLOOMSTRAND MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062907

License Status

CANCELLED

Business

Title

First Name

KURT

Last Name

BLOOMSTRAND

Business Name

KURT BLOOMSTRAND MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2016

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

03/24/2014