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Licensing details for: 15319

Name: PANSAWIRA, IRIN

License Type: Optometrist

Primary Status: Current Primary Status Definition

Specialty: TLGPrimary Status Definition

Address of Record

4455 W 117th St
Ste 105
HAWTHORNE CA 90250-2240
LOS ANGELES county
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Issuance Date

June 24, 2015

Expiration Date

April 30, 2026

Current Date / Time

November 6, 2025
7:7:16 PM

License Relationships

Registered Dispensing Optician/Optometrist Co-Location

License/Registration Role: Optometrist

Related Party Role: Registered Dispensing Ophthalmic Business

Name: TARGET OPTICAL #2409

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 70546 Primary Status: Current

Address :
5104 Commons Dr
ROCKLIN CA 95677-3911
PLACER COUNTY

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