DAVID L BLOOM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036073934

License Status

INACTIVE

Business

First Name

DAVID L

Last Name

BLOOM

Suffix

Business Name

DAVID L BLOOM MD

Original Issue Date

10/07/1986

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

BOSTON

State

Zip

02116

County

MASSACHUSETTS

Ever Disciplined

LastModifiedDate

04/07/2011