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Licensing details for: 13083

Name: PARK, VANESSA CEBALLOS

License Type: Optometrist

Primary Status: Current Primary Status Definition

Specialty: TLGPrimary Status Definition

Address of Record

30340 Haun Rd
Target Optical
MENIFEE CA 92584-6806
RIVERSIDE county
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Issuance Date

July 19, 2006

Expiration Date

December 31, 2026

Current Date / Time

November 5, 2025
11:49:39 PM

License Relationships

Registered Dispensing Optician/Optometrist Co-Location

License/Registration Role: Optometrist

Related Party Role: Registered Dispensing Ophthalmic Business

Name: TARGET OPTICAL #4470

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7504 Primary Status: Current

Address :
30340 HAUN ROAD
MENIFEE CA 92584
RIVERSIDE COUNTY

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