California State Board of Optometry
Licensing details for: 6748
Name: SAM'S CLUB #4709
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current

Address of Record
1375 E Ontario Ave
CORONA CA 92881-6604
RIVERSIDE 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: MATSUMOTO, RANDALL KEITH
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1376 Primary Status: Current
Address :
26142 Williams Way
B
MURRIETA CA 92563-7377
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Maya, Erika Alexandra
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43014 Primary Status: Current
Address :
1375 E Ontario Ave
CORONA CA 92881-6604
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: MATSUMOTO, RANDALL KEITH
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5064 Primary Status: Current
Address :
26142 Williams Way
B
MURRIETA CA 92563
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: PEREZ, CRYSTAL CORA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40404 Primary Status: Current
Address :
19430 Envoy Ave
CORONA CA 92881-3804
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: ramirez ortega, mayra elisa
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 41482 Primary Status: Current
Address :
1820 Rainbow Ridge St
CORONA CA 92882-5147
RIVERSIDE COUNTY



