ALEXANDRIA P VICENCIO Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****59

License Status

ACTIVE

Business

First Name

ALEXANDRIA

Middle

Last Name

VICENCIO

Business Name

ALEXANDRIA P VICENCIO

Original Issue Date

12/03/2023

Effective Date

03/26/2026

Expiration Date

05/31/2028

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/26/2026