JUSTIN DAVID BLOOMBERG DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065787

License Status

CANCELLED

Business

Title

First Name

JUSTIN

Middle

DAVID

Last Name

BLOOMBERG

Business Name

JUSTIN DAVID BLOOMBERG DO

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

05/28/2015