California State Board of Optometry

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: HADDAD, HANAN EMIL

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5507 Primary Status: Cancelled

Address :
6323 SURFBIRD LANE
ROCKLIN CA 95765
PLACER COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Espinoza, Micaela

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 43660 Primary Status: Current

Address :
9672 Endsleigh Ct
GRANITE BAY CA 95746-6648

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: ADAMS, RACHELL GENEA

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40393 Primary Status: Delinquent

Address :
7924 Daffodil Way
CITRUS HEIGHTS CA 95610-2628
SACRAMENTO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: FERRANTE, GEORGE MICHAEL

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5479 Primary Status: Cancelled

Address :
6102 TEMPLETON DR
CARMICHAEL CA 95608
SACRAMENTO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: KOSHELL, BRANDON LEERIN

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5934 Primary Status: Current

Address :
5345 Sunrise Blvd
FAIR OAKS CA 95628-3546
SACRAMENTO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: WILLSON, SUZIE M

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 971 Primary Status: Cancelled

Address :
4562 WATERVILLE DR
SAN JOSE CA 95118
SANTA CLARA COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: PIZHENKOV, LARISA

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4664 Primary Status: Cancelled

Address :
8583 TRAVARY WAY
ANTELOPE CA 95843-5879
SACRAMENTO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Cromwell, Andrew Stephen

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 42075 Primary Status: Current

Address :
1151 Galleria Blvd
STE #175
ROSEVILLE CA 95678-1937
PLACER COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: SIPPLE, MARGARET E

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5561 Primary Status: Cancelled

Address :
1727 RUSSELL WAY
ROSEVILLE CA 95661
PLACER COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Scudder, Victoria Vy

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 42373 Primary Status: Current

Address :
26375 Plumcot Dr
TEMESCAL VALLEY CA 92883-3014

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: PAVLICA, JOHN JOSEPH

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5953 Primary Status: Cancelled

Address :
320 OAK VIEW COURT
AUBURN CA 95603
PLACER COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: JONES, CHRISTOPHER

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5657 Primary Status: Cancelled

Address :
11543 QUARTZ DR APT #4
AUBURN CA 95602
PLACER COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: BAKER, LAURA LORAINE

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6134 Primary Status: Cancelled

Address :
1200 CREEKSIDE DRIVE SUITE 817
FOLSOM CA 95630
SACRAMENTO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: GENDJAR, REBECCA LYNN

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 6494 Primary Status: Cancelled

Address :
8112 DEER SPRING CIR
ANTELOPE CA 95843
SACRAMENTO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Lima, Andrew Joseph

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41139 Primary Status: Current

Address :
PO Box 3053
ROCKLIN CA 95677-8475
PLACER COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Sabillo, Rashelle

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 43566 Primary Status: Current

Address :
1151 Galleria Blvd. Suite 175
ROSEVILLE CA 95678
SACRAMENTO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Lester, Emily

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41749 Primary Status: Cancelled

Address :
1151 Galleria Blvd
ste 175
ROSEVILLE CA 95678

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: ARRIAGA, ADRIAN A

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41769 Primary Status: Cancelled

Address :
110 Sanborn Ct
FOLSOM CA 95630-2238

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Bakalor, Michael

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 43554 Primary Status: Current

Address :
3113 Lazy J Ct
ANTELOPE CA 95843-4451
SACRAMENTO COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: NGO, AARON

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5627 Primary Status: Cancelled

Address :
2889 AUTUMN FALLS LANE
LINCOLN CA 95648
PLACER COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: Alvarado, Mark Ongkingco

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40138 Primary Status: Current

Address :
1416 Dorchester Dr
ROSEVILLE CA 95678-6941
PLACER COUNTY

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License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Optometrist

Name: PATEL, AVANI J

License/Registration Type: Optometrist

License Number: 10548 Primary Status: Current

Address :
10951 CHERRY STREET SUITE 101
LOS ALAMITOS CA 90720
ORANGE COUNTY

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