| | Physician Last Name: | Vicencio |
| | Physician First Name: | Vaila |
| | Physician Middle Name: | Sison |
| | Address: | Marlborough Ridge,
20960 East Walnut Road,
Walnut, California 91789 |
| | License Number: | 159453 |
| | License Type: | MD |
| | Year of Birth: |
1953
|
| | Effective Date: | 04/11/2000 |
| | Action Description for DOH Webpage: | License surrender |
| | Misconduct Description for DOH Webpage: | The physician did not contest the charge of having been disciplined by the California State Medical Board for his inability to safely practice medicine due to his psychiatric condition |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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