California State Board of Optometry

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Castaneda, Salma Jada

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 43415 Primary Status: Current

Address :
40820 Winchester Rd Ste 1360
TEMECULA CA 92591-5533
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: RODRIGUEZ, GINA L

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6175 Primary Status: Current

Address :
180 S Terra Cotta Rd
LAKE ELSINORE CA 92530-5183
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: BABA, SAMUEL NICHOLAS

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40583 Primary Status: Cancelled

Address :
217 Melinda Way
OCEANSIDE CA 92057-7374
SAN DIEGO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: FARNBACH, REBECCA MARSHALL

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5700 Primary Status: Cancelled

Address :
41403 BITTER CREEK CT
TEMECULA CA 92591
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: POTAPA, CHRISTOPHER ALLAN

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40731 Primary Status: Current

Address :
30359 Terrain St
MURRIETA CA 92563-1820
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: CHAVEZ, JULIO CESAR

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40631 Primary Status: Cancelled

Address :
11795 SW Tualatin Rd
#80
TUALATIN OR 97062-7444
WASHINGTON COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Franco JR III, Rigoberto

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 42703 Primary Status: Current

Address :
8442 Vicki Dr
WHITTIER CA 90606-3232
LOS ANGELES COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: BROWER, BILL J

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4924 Primary Status: Cancelled

Address :
49780 WINDSONG WAY
AGUANGA CA 92536
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: DIAMOND, ANDREW F

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41051 Primary Status: Cancelled

Address :
26244 Charismatic Ct
MORENO VALLEY CA 92555-3389
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Smith, Shaylee Jayne

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 43125 Primary Status: Current

Address :
3601 W Florida Ave
HEMET CA 92545-3514
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Johnston, Kendra Danielle

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41177 Primary Status: Cancelled

Address :
PO Box 2934
SUN CITY CA 92586-8934
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: RIVERA, MICHAEL ANTHONY

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40698 Primary Status: Current

Address :
9361 Alto Dr
LA MESA CA 91941-4225
SAN DIEGO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: MORALES, JOSE JESUS

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40773 Primary Status: Current

Address :
3909 Reche Road
Space 113
FALLBROOK CA 92028
SAN DIEGO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Bohanan, Reid

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 42994 Primary Status: Current

Address :
25149 Calle Viejo
MURRIETA CA 92563-5279
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: WOODALL, CHERYL LYN

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5099 Primary Status: Cancelled

Address :
32212 CORTE GARDANO
TEMECULA CA 92592
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: KEPLAR, JAUNA L

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40622 Primary Status: Current

Address :
26100 ynez rd
TEMECULA CA 92591
RIVERSIDE COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: BATES, RUBY LESLIE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41006 Primary Status: Delinquent

Address :
1056 Grossmont Dr
WHITTIER CA 90601-1143
LOS ANGELES COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Hunt, Robert Jason

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 42986 Primary Status: Current

Address :
29297 Beachcomber Dr
MENIFEE CA 92585-3115

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: NESBETH, ABRAHAM RAFAEL

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41273 Primary Status: Delinquent

Address :
910 Del Dios Rd
63
ESCONDIDO CA 92029-2245
SAN DIEGO COUNTY

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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

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