ERNEST DAVID BLOOMENTHAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

ERNEST DAVID

Last Name

BLOOMENTHAL

Suffix

Business Name

ERNEST DAVID BLOOMENTHAL MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1981

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006