MARK E WEAVER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062627

License Status

NOT RENEWED

Business

First Name

MARK E

Last Name

WEAVER

Suffix

Business Name

MARK E WEAVER MD

Original Issue Date

07/27/1981

Effective Date

06/12/2017

Expiration Date

09/30/2020

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/14/2021