California State Board of Optometry

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: ICHINOSE, MICHAEL TARO

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4806 Primary Status: Cancelled

Address :
PO BOX 922
GOLETA CA 93116
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Hedges, Samantha Quinn

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41617 Primary Status: Cancelled

Address :
2133 Campton circle
GOLD RIVER CA 95670

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: BARCENAS, JOSE MORALES JR

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5728 Primary Status: Cancelled

Address :
2121 DAILY DRIVE
CAMARILLO CA 93010
VENTURA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: GLENN, DOUGLAS T

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40533 Primary Status: Current

Address :
9407 Petit Cir
VENTURA CA 93004-2213
VENTURA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: REYES, ABEL

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4836 Primary Status: Cancelled

Address :
376 OAKTREE WAY
BUELLTON CA 93427
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: RAMIREZ, CRYSTAL YESENIA

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6639 Primary Status: Cancelled

Address :
14635 ARIZONA ST
FONTANA CA 92336
SAN BERNARDINO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: KENNER, CLAUDETTE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4460 Primary Status: Cancelled

Address :
651 WHEELER ST
SANTA ROSA CA 95404
SONOMA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: THIEM, CHRISTINE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40027 Primary Status: Cancelled

Address :
7005 Delos Dr
SAN DIEGO CA 92139-2107
SAN DIEGO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: RINCON, DANIEL MAGANA

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40144 Primary Status: Cancelled

Address :
450 Bridgevale Rd
HOLLISTER CA 95023-3247
SAN BENITO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: FINLEY, JOHN DANIEL

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4624 Primary Status: Cancelled

Address :
827 E FIGUEROA ST
SANTA BARBARA CA 93103
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: MEDEIROS, ALLYN SANG LOK

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4367 Primary Status: Cancelled

Address :
6750 EL COLEGIO RD, #104
GOLETA CA 93117
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: GIL, ARTURO

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6372 Primary Status: Cancelled

Address :
33 SAN MATEO AVENUE
GOLETA CA 93117
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: MCDONEL, KELLY

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5231 Primary Status: Cancelled

Address :
713 PIVOT POINT WAY
OXNARD CA 93035
VENTURA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Medina, Saul

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41659 Primary Status: Cancelled

Address :
1140 E Lomita Ave
GLENDALE CA 91205-1332
LOS ANGELES COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: SANCHEZ, VALERIE JEAN

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4834 Primary Status: Cancelled

Address :
7761 JENNA DR
GOLETA CA 93117
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Hammel, REBECCA Ferrone

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5623 Primary Status: Current

Address :
5688 Cathedral Oaks Rd
GOLETA CA 93117-1833
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: PILATO, JOANN MARIE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6302 Primary Status: Cancelled

Address :
7730 GARNET STREET
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: CARDONA, RIGO

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40978 Primary Status: Current

Address :
3855 State St
SANTA BARBARA CA 93105-3152
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: DANIEL, SONIA BEATRIZ

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4796 Primary Status: Current

Address :
3610 W Elowin Ave
VISALIA CA 93291-0024
TULARE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: PERONA, SARA JOANNE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6139 Primary Status: Cancelled

Address :
330 E Enos Dr Apt 66
SANTA MARIA CA 93454-7274
SANTA BARBARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Tokhmakhian, Ani

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41371 Primary Status: Cancelled

Address :
6581 Del Playa Dr
GOLETA CA 93117-5183

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Optometrist

Name: KAWAGUCHI, GLENN KEVIN O.D.

License/Registration Type: Optometrist

License Number: 9986 Primary Status: Current

Address :
3855 State St
SANTA BARBARA CA 93105-3152
SANTA BARBARA COUNTY

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