License holder summary

GEORGE R BLOOM is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for GEORGE R BLOOM is 236 SIMPSON STREET, ELKHART IN 46516. This licensed professional license is not current. The license was granted 04/30/1986 and expired on 04/30/1987.

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 2024-04-06 03:01:41 UTC

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