KENNETH WEAVER

Idaho  M-5106   Canceled

This Idaho license was held by KENNETH WEAVER. The license is no longer active. It was granted on 07/11/1986 and expired on 06/30/1988

LICENSE DETAILS

  • License Number: M-5106
  • Category: Board Of Medicine
  • Status: Canceled
  • Date Granted: 07/11/1986 (almost 38 years ago)
  • Expiry Date: 06/30/1988 (almost 36 years ago)

LOCATIONS

A Residential

Suite 6, 311 Princeton Road Johnson City TN 37601