California State Board of Optometry

Licensing details for: 6742

Name: TARGET OPTICAL SHOP #4204

License Type: Registered Dispensing Ophthalmic Business

Primary Status: Cancelled Primary Status Definition

Address of Record

10620 FIRESTONE BLVD
NORWALK CA 90650
LOS ANGELES county
Map

Issuance Date

August 23, 2001

Expiration Date

August 31, 2009

Current Date / Time

November 6, 2025
9:53:4 AM

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: BALAM, NICO

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4478 Primary Status: Current

Address :
12706 WALDORF DR
LYNWOOD CA 90262
LOS ANGELES COUNTY

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: GILBERT, MELISSA RENEE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4632 Primary Status: Cancelled

Address :
1815 N ANZAC AVENUE
COMPTON CA 90222
LOS ANGELES COUNTY