License holder summary

LUCIA FERNANDA FONTALVO-HERAZO is a Medicine - Institutional License licensed to practice in Pennsylvania. The address on file for LUCIA FERNANDA FONTALVO-HERAZO is Philadelphia PA 19104. This licensed professional license is not current. The license was granted 04/02/2007 and expired on 04/01/2010.

Pennsylvania

Department of State

LUCIA FERNANDA FONTALVO-HERAZO
Medicine - Institutional License
License number
LT000622
Date granted
04/02/2007
Date expires
04/01/2010
Class
Medicine - Institutional License
Status
Expired
Address
Philadelphia PA 19104
palicensing.org
ID 16622875
LAST UPDATED 2026-03-25 03:56:57 UTC

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