ROBERT W BLOOM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****02

License Status

NOT RENEWED

Business

First Name

ROBERT W

Last Name

BLOOM

Suffix

Business Name

ROBERT W BLOOM MD

Original Issue Date

09/26/1984

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

ZION

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021