California State Board of Optometry

Licensing details for: 6845

Name: TARGET OPTICAL SHOP #4256

License Type: Registered Dispensing Ophthalmic Business

Primary Status: Cancelled Primary Status Definition

Address of Record

1893 MALVERN AVE
FULLERTON CA 92832
ORANGE county
Map

Issuance Date

May 24, 2002

Expiration Date

May 31, 2010

Current Date / Time

November 6, 2025
2:57:46 AM

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: RAPHAEL, SCOTT BRADLEY

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 5321 Primary Status: Cancelled

Address :
12750 CENTRALIA ST #118
LAKEWOOD CA 90715
LOS ANGELES COUNTY

License/Registration Role: Registered Dispensing Ophthalmic Business

Related Party Role: Registered Spectacle Lens Dispenser

Name: HAMMONS, LESLIE H

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 4074 Primary Status: Cancelled

Address :
SAMS CLUB #6609
34220 MONTEREY AVE
PALM DESERT CA 92211
RIVERSIDE COUNTY