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Licensing details for: 11460

Name: BALDWIN, SUSAN MARY

License Type: Optometrist

Primary Status: Current Primary Status Definition

Specialty: TLGPrimary Status Definition

Address of Record

430 Blue Ravine Rd
FOLSOM CA 95630-3402
SACRAMENTO county
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Issuance Date

August 7, 2000

Expiration Date

April 30, 2026

Current Date / Time

November 7, 2025
12:55:57 AM

License Relationships

Registered Dispensing Optician/Optometrist Co-Location

License/Registration Role: Optometrist

Related Party Role: Registered Dispensing Ophthalmic Business

Name: TARGET OPTICAL #4789

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 70837 Primary Status: Current

Address :
430 Blue Ravine Rd
FOLSOM CA 95630-3402
SACRAMENTO COUNTY

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Statement of Licensure to Optometrist

License/Registration Role: Optometrist

Related Party Role: Statement of Licensure

Name: BALDWIN, SUSAN MARY

License/Registration Type: Statement of Licensure

License Number: 13720 Primary Status: Current

Address :
7147 Greenback Ln
CITRUS HEIGHTS CA 95621-5526
SACRAMENTO COUNTY

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