JULIE DOMINICK VICENCIO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****51

License Status

ACTIVE

Business

First Name

JULIE

Middle

DOMINICK

Last Name

VICENCIO

Business Name

JULIE DOMINICK VICENCIO

Original Issue Date

08/20/2015

Effective Date

03/15/2026

Expiration Date

05/31/2028

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/15/2026