JESSICA L BLOOM-FOSTER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

JESSICA

Middle

Last Name

BLOOM-FOSTER

Business Name

JESSICA L BLOOM-FOSTER

Original Issue Date

06/08/2004

Effective Date

06/08/2004

Expiration Date

07/31/2005

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006