California State Board of Optometry
Licensing details for: 5729
Name: COSTCO WHOLESALE CORPORATION
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Cancelled
Address of Record
1300 DANA DRIVE
REDDING CA 96003
SHASTA county
Map
License Relationships
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: HULSEMAN, BUCKLEY SHELBY
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1336 Primary Status: Cancelled
Address :
684 Springer Dr
REDDING CA 96003-4565
SHASTA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: ROBINSON, ANTONIO MARQUES
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8110 Primary Status: Current
Address :
1588 Chestnut St
REDDING CA 96001-1645
SHASTA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Gould, Jennifer Noel
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8814 Primary Status: Current
Address :
PO Box 492881
REDDING CA 96049-2881
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: BUTWIN, BARRY ALEXANDRE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 7992 Primary Status: Cancelled
Address :
2214 Daley Rd
CHAPEL HILL NC 27514-5123
ORANGE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: HANNA, SAMUEL MARK
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1434 Primary Status: Current
Address :
2155 Park Marina Dr
39
REDDING CA 96001-0956
SHASTA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: RUNCIMAN, JOHN DOUGLAS
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8317 Primary Status: Cancelled
Address :
7621 Pit Rd
REDDING CA 96001-5395
SHASTA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: KWIATKOWSKI, JESSICA MARIE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1658 Primary Status: Current
Address :
11800 Fourth St
RANCHO CUCAMONGA CA 91730-6129
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: COFFEY, GLENN KEVIN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1712 Primary Status: Cancelled
Address :
3278 WANDSWORTH DRIVE
SHASTA LAKE CA 96003
SHASTA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: PILLSBURY, ERIN SUZANNE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2086 Primary Status: Cancelled
Address :
3190 Churn Creek Rd
REDDING CA 96002-2122
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: HANNA, SAMUEL MARK
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5145 Primary Status: Current
Address :
2155 Park Marina Dr
39
REDDING CA 96001-0956
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: NORCROSS, JENNIFER LYNN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4718 Primary Status: Cancelled
Address :
PO BOX 1041
COTTONWOOD CA 96002
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: PILLSBURY, ERIN SUZANNE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6303 Primary Status: Cancelled
Address :
4354 BLAZXINGWOOD
REDDING CA 96001
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: BUTWIN, BARRY ALEXANDRE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40081 Primary Status: Cancelled
Address :
851 Lake Blvd
REDDING CA 96003-2233
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: COFFEY, GLENN KEVIN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4449 Primary Status: Cancelled
Address :
3278 WANDSWORTH DRIVE
SHASTA LAKE CA 96019
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: HULSEMAN, BUCKLEY SHELBY
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4022 Primary Status: Cancelled
Address :
684 SPRINGER DRIVE
REDDING CA 96003
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: RUNCIMAN, JOHN DOUGLAS
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 41003 Primary Status: Cancelled
Address :
7621 Pit Rd
REDDING CA 96001-5395
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Robinson, Antonio Marques
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40104 Primary Status: Current
Address :
1588 Chestnut St
REDDING CA 96001-1645
SHASTA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: KWIATKOWSKI, JESSICA MARIE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4938 Primary Status: Current
Address :
11800 Fourth St
RANCHO CUCAMONGA CA 91730-6129
SAN BERNARDINO COUNTY
