License holder summary

MANTILLA FANNY JANETH is a Medicine (Physician, Including M Ds & D Os) licensed to practice in New York. The address on file for MANTILLA FANNY JANETH is EDGEWATER NJ. This doctor license is current. The license was granted 12/23/1998 and expired on 08/31/2016.

New York

Office of the Professions

MANTILLA FANNY JANETH
Medicine (Physician, Including M Ds & D Os)
License number
212807
Date granted
12/23/1998
Date expires
08/31/2016
Class
Medicine (Physician, Including M Ds & D Os)
Status
Registered
Address
EDGEWATER NJ
nymedicine.org
ID 30212682
LAST UPDATED 2024-03-06 08:04:31 UTC

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