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Licensing details for: 7890

Name: University Avenue Optometry

License Type: Fictitious Name Permit

Primary Status: Current Primary Status Definition

Address of Record

270 University Ave
PALO ALTO CA 94301-1713
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Issuance Date

November 20, 2023

Expiration Date

January 31, 2026

Current Date / Time

November 6, 2025
6:58:37 PM

License Relationships

Fictitious Name Permit to Optometrist

License/Registration Role: Fictitious Name Permit

Related Party Role: Optometrist

Name: FONG, VERISSA LAM

License/Registration Type: Optometrist

License Number: 15279 Primary Status: Current

Address :
1001 Springfield Dr
MILLBRAE CA 94030-1547
SAN FRANCISCO COUNTY

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