GEORGE R BLOOM

Controlled Substance Registration - Physician

Indiana  01013976B   Expired

This Indiana license was held by GEORGE R BLOOM. The license is no longer active. It was granted on 04/30/1986 and expired on 04/30/1987

LICENSE DETAILS

  • License Number: 01013976B
  • Category: CSR-Physician
  • Status: Expired
  • Date Granted: 04/30/1986 (about 39 years ago)
  • Expiry Date: 04/30/1987 (about 38 years ago)

LOCATIONS

A Address

236 SIMPSON STREET, ELKHART IN 46516