California State Board of Optometry
Licensing details for: 6980
Name: SAM'S CLUB 6620
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
2495 IRON POINT RD #11
FOLSOM CA 95630
SACRAMENTO 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: FORTIER, KATY LYNN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2093 Primary Status: Cancelled
Address :
1265 PACIFIC AVE APT 15
SANTA ROSA CA 95404
SONOMA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: LAVARIAS, ELAINE ANNETTE SABANGAN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1322 Primary Status: Current
Address :
429 Gosser St
MILPITAS CA 95035-2640
SANTA CLARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: KENNEDY, PAMELA JO
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1864 Primary Status: Current
Address :
1136 SANDY CREEK DRIVE
FOLSOM CA 95630
SACRAMENTO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: MCPHERSON, THEODORE R
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1379 Primary Status: Cancelled
Address :
2100 VALLEY VIEW PKWY # 824
EL DORADO HILLS CA 95762
EL DORADO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: BIELEFIELD, KATHRYN ELAINE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40596 Primary Status: Cancelled
Address :
1780 Creekside Drive Apt 314
FOLSOM CA 95630
SACRAMENTO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: KENNEDY, PAMELA JO
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6757 Primary Status: Current
Address :
1136 SANDY CREEK DRIVE
FOLSOM CA 95630
SACRAMENTO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Montes, Michelle
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 41641 Primary Status: Delinquent
Address :
9115 Newhall Dr
3
SACRAMENTO CA 95826
SACRAMENTO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: LAVARIAS, ELAINE ANNETTE SABANGAN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 4565 Primary Status: Current
Address :
429 Gosser St
-
-
MILPITAS CA 95035-2640
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: HARMON-BEAVERS, LISA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6040 Primary Status: Delinquent
Address :
809 SW 3rd St
B
BRYANT AR 72022-3376
SALINE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: FORTIER, KATY LYNN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6320 Primary Status: Cancelled
Address :
1265 PACIFC AVE APT 15
SANTA ROSA CA 95404
SONOMA COUNTY
