KELLY BERNARD WEAVER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104959

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

BERNARD

Last Name

WEAVER

Suffix

Business Name

KELLY BERNARD WEAVER MD

Original Issue Date

06/12/2001

Effective Date

06/12/2001

Expiration Date

07/31/2002

City

SAMMAMISH

State

Zip

98074

County

WASHINGTON

Ever Disciplined

LastModifiedDate

10/09/2006