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Licensing details for: 14876

Name: Baek, Jennifer

License Type: Statement of Licensure

Primary Status: Current Primary Status Definition

Address of Record

301 S Western Ave
STE 103
LOS ANGELES CA 90020-3831
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Issuance Date

November 15, 2023

Expiration Date

October 31, 2025

Current Date / Time

October 5, 2024
11:50:34 AM

License Relationships

Statement of Licensure to Optometrist

License/Registration Role: Statement of Licensure

Related Party Role: Optometrist

Name: Baek, Jennifer

License/Registration Type: Optometrist

License Number: 35051 Primary Status: Current

Address :
301 S Western Ave
Ste 103
LOS ANGELES CA 90020-3831
LOS ANGELES COUNTY

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