Idaho
Division of Occupational and Professional Licenses
KENNETH WEAVER
Board Of Medicine
License number
M-5106
Date granted
07/11/1986
Date expires
06/30/1988
Class
Board Of Medicine
Status
Canceled
Address
Suite 6, 311 Princeton Road Johnson City TN 37601
idaholicensing.com
ID 48339269
LAST UPDATED 2026-03-20 13:50:41 UTC
LAST UPDATED 2026-03-20 13:50:41 UTC
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