California State Board of Optometry
Licensing details for: 6734
Name: SAM'S CLUB #6619
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
951 N MILLIKEN AVE
ONTARIO CA 91764-5008
SAN BERNARDINO 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: TAKAHASHI, CHRISTINE ELAINE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1350 Primary Status: Cancelled
Address :
1055 E HARRIMAN PLACE
SAN BERNARDINO CA 92408
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: BOWENS, RICHARD E
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1213 Primary Status: Cancelled
Address :
26198 PERRY WAY
HIGHLAND CA 92346
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: LICON, NIKI - RAE ALEXIS
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8249 Primary Status: Current
Address :
1555 N Elderberry Ct
ONTARIO CA 91762-1022
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: MODLIN, KAREN DENISE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1560 Primary Status: Cancelled
Address :
14442 CONEJO ST
VICTORVILLE CA 92392-7626
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: GONZALEZ, MELISSA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2226 Primary Status: Current
Address :
30049 Big Country Dr
MENIFEE CA 92584-1304
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: SANCHEZ, PETE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1307 Primary Status: Cancelled
Address :
9443 ALDER STREET
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: PEREZ, ADRIAN JOSEPH
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6530 Primary Status: Current
Address :
2270 AVENIDA LA PAZ
CHINO HILLS CA 91709
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: DISMUKE, GLENN AUSTIN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4637 Primary Status: Cancelled
Address :
4972 LAMIA WAY
OCEANSIDE CA 92056
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: LICON, NIKI - RAE ALEXIS
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40958 Primary Status: Current
Address :
1555 N Elderberry Ct
ONTARIO CA 91762-1022
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: SANCHEZ, PETE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5319 Primary Status: Cancelled
Address :
9443 ALDER ST
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: GONZALEZ, MELISSA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6748 Primary Status: Delinquent
Address :
30049 Big Country Dr
MENIFEE CA 92584-1304
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: BOWENS, RICHARD E
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4235 Primary Status: Cancelled
Address :
26198 PERRY WAY
HIGHLAND CA 92346
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: TRAN, KIM TO
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5405 Primary Status: Cancelled
Address :
5301 ALMADEN EXPRESSWAY
SAN JOSE CA 95118
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: DUFFEY, DAMARIS MARISA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5141 Primary Status: Cancelled
Address :
PTY 11124-11010 NW 30TH ST STE 104
DORAL FL 33172-5032
MIAMI-DADE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: KUGLER, WENDY ANN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 3880 Primary Status: Cancelled
Address :
5024 MT LA PLATTA DR
SAN DIEGO CA 92117
SAN DIEGO COUNTY
