California State Board of Optometry

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: DEWITTE, ANDREW VINCENT

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6263 Primary Status: Cancelled

Address :
3614 32ND ST UNIT B
SAN DIEGO CA 92104
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Morales, Alyssa Andrea

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 43183 Primary Status: Current

Address :
8301 Rio San Diego Dr Unit 4
SAN DIEGO CA 92108-5687
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: MULLERT, BETHANY ROSE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40071 Primary Status: Current

Address :
8030 La Mesa Blvd # 136
LA MESA CA 91942-0335
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: BARCELLS, ADRIANA CARESSE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6198 Primary Status: Current

Address :
706 NE 2nd St
APT 7
FORT LAUDERDALE FL 33301-1690
BROWARD COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Jaski, Richard

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41607 Primary Status: Current

Address :
4444 Parks Ave
6
LA MESA CA 91941

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Inbody, Rebecca Marie

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41148 Primary Status: Delinquent

Address :
719 Trillium Cir
MARYVILLE TN 37804-3655
BLOUNT COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: BAUMEISTER, KAREN

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6275 Primary Status: Cancelled

Address :
3306 Hawk St
SAN DIEGO CA 92103-5340
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Waltz, Sara

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 42188 Primary Status: Delinquent

Address :
1950 Camino De La Reina Unit 116
SAN DIEGO CA 92108-5512
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: HEIM, WILLIAM RANDEL

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 3613 Primary Status: Cancelled

Address :
3502 ANGWIN DR
SAN DIEGO CA 92123
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: NEWMAN, JILLIAN J

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6795 Primary Status: Cancelled

Address :
29214 HIDDEN MEADOW DRIVE
MENIFEE CA 92584
RIVERSIDE COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: AZARKIAN, AFSHIN

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5251 Primary Status: Current

Address :
8402 Blossom Ln
LEMON GROVE CA 91945-4229
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Martinez Ortiz, Judith

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 42767 Primary Status: Current

Address :
1640 Camino Del Rio N Ste 200
SAN DIEGO CA 92108-1523
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: HERNANDEZ, ELVIRA BERUMEN

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5538 Primary Status: Cancelled

Address :
32739 WHISPERING PALMS AVE
CATHEDRAL CITY CA 92234
RIVERSIDE COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: CARREON, GINNO-BENEDICT Talavera

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40073 Primary Status: Current

Address :
6780 Miramar Rd Ste 203
SAN DIEGO CA 92121-2639
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: RENDON, JUAN CARLOS

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40607 Primary Status: Cancelled

Address :
3420 LeBon Dr
Apt. 3317
SAN DIEGO CA 92122-5223
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: ESOLA, ELIZABETH BERNICE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6444 Primary Status: Current

Address :
4444 Kendall St
#4
SAN DIEGO CA 92109
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: O'MALLEY, CLARE KALEOALOHA

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5187 Primary Status: Cancelled

Address :
3726 28TH ST
SAN DIEGO CA 92104
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: ORTIZ, JOHN ISAAC

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40681 Primary Status: Current

Address :
1818 Burton St
SAN DIEGO CA 92111-7006
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: LANDIS, MICHAEL W

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5771 Primary Status: Cancelled

Address :
1546 Brandon Ave
CINCINNATI OH 45230-1887
HAMILTON COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: GOMEZ, SERGIO

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5969 Primary Status: Cancelled

Address :
5076 Santa Fe St Ste A
SAN DIEGO CA 92109-1634
SAN DIEGO COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: CADION, JOHANNA C

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4923 Primary Status: Current

Address :
7724 Canterbury Ln
DUBLIN CA 94568-1936
ALAMEDA COUNTY

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Alsaegh, Fadi

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41283 Primary Status: Delinquent

Address :
1628 Danny Ln
EL CAJON CA 92021-1010

Map

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Optometrist

Name: SULJUKI, LAHEQA

License/Registration Type: Optometrist

License Number: 33411 Primary Status: Current

Address :
1640 Camino Del Rio N Ste 200
SAN DIEGO CA 92108-1523
SAN DIEGO COUNTY

Map