RICHARD ALAN BLOOM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

INACTIVE

Business

First Name

RICHARD ALAN

Last Name

BLOOM

Suffix

Business Name

RICHARD ALAN BLOOM MD

Original Issue Date

09/03/1981

Effective Date

09/03/1981

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006