California State Board of Optometry
Licensing details for: 6856
Name: COSTCO WHOLESALE #678
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
11800 4TH STREET
RANCHO CUCAMONGA CA 91730
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: BURKS, STACINA MAXINE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1822 Primary Status: Cancelled
Address :
1601 WINTERGREEN LN UNIT D
CORONA CA 92879
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: COLLINS, MARGARET FRANCES
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1358 Primary Status: Cancelled
Address :
9152 C AVENUE SP 7
HESPERIA CA 92345
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: LIRA, MARY KATHERINE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1671 Primary Status: Cancelled
Address :
12232 GATHERING PL APT E
EASTVALE CA 91752
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Ansevics, Debra Susan
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9184 Primary Status: Current
Address :
4063 Opal St
JURUPA VALLEY CA 92509-7263
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: VILLASENOR, EVETTE CHRISTINA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 7964 Primary Status: Cancelled
Address :
1006 W Ralston St
ONTARIO CA 91762-4843
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: GUERRERO, MARCELA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1843 Primary Status: Current
Address :
3336 S North Shore Dr
ONTARIO CA 91761-9124
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: BRUNS, ROBERT LLOYD
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8201 Primary Status: Cancelled
Address :
144 S. Palo Cedro Dr
DIAMOND BAR CA 91765
LOS ANGELES COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: WHITE, CANDICE FAYE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1984 Primary Status: Delinquent
Address :
17877 Aloe Ln
RIVERSIDE CA 92503-7028
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: DARNALL, PHILIP PATRICK
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1327 Primary Status: Cancelled
Address :
79-795 HIGHWAY 111
LA QUINTA CA 92253
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: SADIQ, QUDSIA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1674 Primary Status: Cancelled
Address :
9829 Cinch Ring Ln
ALTA LOMA CA 91737-1614
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Plascencia, Ramon
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8278 Primary Status: Current
Address :
9711 Adobe Rd
OAK HILLS CA 92344-0812
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: rodriguez, jaclyn rose
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9163 Primary Status: Current
Address :
740 W 19th St
SAN BERNARDINO CA 92405-4239
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: EUSOOF, ELIZABETH GOMEZ
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2080 Primary Status: Current
Address :
2974 E Arbor Ln
ONTARIO CA 91762-7217
SAN BERNARDINO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: TORREZ, ROBERT JASON
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1672 Primary Status: Cancelled
Address :
11050 BRYANT ST # 282
YUCAIPA CA 92399
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: DARNALL, PHILIP PATRICK
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4933 Primary Status: Cancelled
Address :
79-795 HIGHWAY 111
LA QUINTA CA 92253
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Ramirez, Aryanna Jaylene
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43344 Primary Status: Current
Address :
1629 Dustin Pl
RIVERSIDE CA 92506-5489
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Ansevics, Debra Susan
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 42714 Primary Status: Current
Address :
4063 Opal St
JURUPA VALLEY CA 92509-7263
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: BRUNS, ROBERT LLOYD
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40793 Primary Status: Cancelled
Address :
144 S. Palo Cedro Dr
DIAMOND BAR CA 91765
LOS ANGELES COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: BURKS, STACINA MAXINE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5774 Primary Status: Cancelled
Address :
1601 WINTERGREEN LN UNIT D
CORONA CA 92879
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: DEIFEL, JANICE DARLENE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 3567 Primary Status: Cancelled
Address :
3116 COVINA ST
BAKERSFIELD CA 93306
KERN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: GUERRERO, MARCELA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4473 Primary Status: Current
Address :
3336 S North Shore Dr
ONTARIO CA 91761-9124
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: COLLINS, MARGARET FRANCES
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 3755 Primary Status: Cancelled
Address :
9152 C AVENUE SP 7
HESPERIA CA 92345
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: VILLASENOR, EVETTE CHRISTINA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40012 Primary Status: Cancelled
Address :
1006 W Ralston St
ONTARIO CA 91762-4843
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: WHITE, CANDICE FAYE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6056 Primary Status: Delinquent
Address :
17877 Aloe Ln
RIVERSIDE CA 92503-7028
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: SADIQ, QUDSIA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5377 Primary Status: Cancelled
Address :
9829 CINCH RING LANE
ALTA LOMA CA 91737
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: rodriguez, jaclyn rose
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43380 Primary Status: Current
Address :
740 W 19th St
SAN BERNARDINO CA 92405-4239
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Plascencia, Ramon
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 41044 Primary Status: Current
Address :
9711 Adobe Rd
OAK HILLS CA 92344-0812
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: EUSOOF, ELIZABETH GOMEZ
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6069 Primary Status: Current
Address :
22366
Savi Ranch Parkway
YORBA LINDA CA 92887
ORANGE COUNTY
