Indiana
Professional Licensing Agency
GEORGE R BLOOM
Controlled Substance Registration - Physician
License number
01013976B
Date granted
04/30/1986
Date expires
04/30/1987
Class
Controlled Substance Registration - Physician
Status
Expired
Address
236 SIMPSON STREET, ELKHART IN 46516
indianalicensing.org
ID 5847270
LAST UPDATED 2026-04-30 19:58:59 UTC
LAST UPDATED 2026-04-30 19:58:59 UTC
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