CANDICE J VICENCIO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****44

License Status

ACTIVE

Business

First Name

CANDICE

Middle

Last Name

VICENCIO

Business Name

CANDICE J VICENCIO

Original Issue Date

04/03/2020

Effective Date

03/25/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026