California State Board of Optometry
Licensing details for: 6844
Name: COSTCO WHOLESALE #473
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
13111 PEYTON DR
CHINO HILLS CA 91709
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: OSUNA, RAFAEL
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1412 Primary Status: Current
Address :
13111 Peyton Dr
CHINO HILLS CA 91709-6002
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: ALVAREZ, ROSA CELIA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1766 Primary Status: Current
Address :
2847 S North Shore Dr
ONTARIO CA 91761-7534
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: DIAZ, ERIKA VIRGINIA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1809 Primary Status: Cancelled
Address :
5792 PORTSMOUTH ST
CHINO CA 91710
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: YIN, BORAMY LENG
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8453 Primary Status: Current
Address :
6920 armour cir
EASTVALE CA 92880
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Kim, Stephen E
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8524 Primary Status: Delinquent
Address :
13111 Peyton Dr
Costco Optical Department
CHINO HILLS CA 91709-6002
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Wong, SANDRA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8392 Primary Status: Current
Address :
438 W Kenoak Dr
COVINA CA 91723-1809
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: FLORES, ESTELA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2068 Primary Status: Current
Address :
7080 Blackbird Ln
EASTVALE CA 92880-9060
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: KERR, VIRGINIA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8205 Primary Status: Current
Address :
16172 Summer Sky Pl
TUSTIN CA 92782-2829
ORANGE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Pham, Khanh-Hong
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8861 Primary Status: Delinquent
Address :
3570 E Pollock St.
2
ONTARIO CA 91761
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: ALAAN, RICHARD JOHN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1699 Primary Status: Current
Address :
8581 Founders Grove Street
CHINO CA 91708
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: KERR, VIRGINIA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40352 Primary Status: Current
Address :
16172 Summer Sky Pl
TUSTIN CA 92782-2829
ORANGE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: DIAZ, ERIKA VIRGINIA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6036 Primary Status: Cancelled
Address :
5792 PORTSMOUTH ST
CHINO CA 91710
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: FLORES, ESTELA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6073 Primary Status: Current
Address :
7080 Blackbird Ln
EASTVALE CA 92880-9060
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: ALVAREZ, ROSA CELIA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5264 Primary Status: Current
Address :
2847 S North Shore Dr
ONTARIO CA 91761-7534
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Wong, SANDRA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40414 Primary Status: Current
Address :
438 W Kenoak Dr
COVINA CA 91723-1809
LOS ANGELES COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: STURM, HEIDI LYNN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 3487 Primary Status: Cancelled
Address :
11814 BROAD OAK COURT
ADELANTO CA 92301
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, MICHAEL
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6373 Primary Status: Revoked
Address :
751 LAREDO
POMONA CA 91768
LOS ANGELES COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: OSUNA, RAFAEL
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5135 Primary Status: Current
Address :
13111 Peyton Dr
Costco Optical Dept.
CHINO HILLS CA 91709-6002
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Montalvo, Valinda Mary
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4901 Primary Status: Current
Address :
1099 E HOSPITALITY LANE
SAN BERNARDINO CA 92408
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: DOMINQUEZ, MICHAEL R
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4017 Primary Status: Current
Address :
20347 Ivy Hill Ln
YORBA LINDA CA 92886-6623
ORANGE COUNTY
