The holder whose full name is BLOOM, A WARD,come from KELLEYS ISLAND OH,hold the Physician license(NO.01013070A) which status is Expired Non-Renewable.
| Name | BLOOM, A WARD |
|---|---|
| License Number | 01013070A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | KELLEYS ISLAND |
| State | OH |