California State Board of Optometry
Licensing details for: 6993
Name: COSTCO WHOLESALE # 775
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
12155 TECH CENTER DR
POWAY CA 92064
SAN DIEGO 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: MAPLE, DEBORAH K
License/Registration Type: Registered Contact Lens Dispenser
License Number: 763 Primary Status: Cancelled
Address :
6026 PASEO ALAMEDA
CARLSBAD CA 92009
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Betancourt, Paul Jacob
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9229 Primary Status: Current
Address :
742 Baylor Ave
CHULA VISTA CA 91913-2002
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: MONDLOCH, SANDRA LYNN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2032 Primary Status: Cancelled
Address :
13005 ASHGATE PLACE
POWAY CA 92064
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: GONZALES, JULIETTE LYN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8193 Primary Status: Current
Address :
1900 Villa Del Dios Gln
ESCONDIDO CA 92029-5321
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: MARSH, PAMELA ANN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1713 Primary Status: Cancelled
Address :
14117 TRICIA ST
POWAY CA 92064
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Huss, Madelyn Adele
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8864 Primary Status: Delinquent
Address :
3003 Flora Rd
LOMPOC CA 93436-9438
SANTA BARBARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Bailey, MICHELLE L
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8156 Primary Status: Current
Address :
38657 Clearbrook Dr
MURRIETA CA 92563-5884
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: PELLEGRINI-CONTI, LISA MARIA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 7984 Primary Status: Current
Address :
10832 Scripps Ranch Blvd
109
SAN DIEGO CA 92131-6021
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: NICHOLAS, MARIAH ROSE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1873 Primary Status: Current
Address :
10827 CARBET PLACE
SAN DIEGO CA 92124
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Gamboa, Andrew Peter
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9284 Primary Status: Current
Address :
2453 Pine Valley Gln
ESCONDIDO CA 92026-1439
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Ayers, Steven Nathaniel
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8965 Primary Status: Current
Address :
13608 Pomerado rd.
apt 19
POWAY CA 92064
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Deinhardt, Kendall Suzanne
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8984 Primary Status: Current
Address :
1515 BOYLE AVE
ESCONDIDO CA 92027
SAN DIEGO COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: TAGLIARENI, ROBYN LYLE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1648 Primary Status: Current
Address :
45875 Warm Springs Parkway
MURRIETA CA 92563
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Scott, Jenevieve Elizabeth
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8981 Primary Status: Current
Address :
12155 Tech Center Dr
POWAY CA 92064-7156
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: HAMILTON, VANESSA RAE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2153 Primary Status: Current
Address :
12435 Old Pomerado Rd
POWAY CA 92064-5327
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: HAMILTON, VANESSA RAE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6506 Primary Status: Current
Address :
12435 Old Pomerado Rd
POWAY CA 92064-5327
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: NICHOLAS, MARIAH ROSE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5849 Primary Status: Current
Address :
10827 CARBET PLACE
SAN DIEGO CA 92124
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: MONDLOCH, SANDRA LYNN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5972 Primary Status: Cancelled
Address :
13005 ASHGATE PLACE
POWAY CA 92064
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: MAPLE, DEBORAH K
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 2108 Primary Status: Cancelled
Address :
6026 PASEO ALAMEDA
CARLSBAD CA 92009
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Deinhardt, Kendall Suzanne
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43091 Primary Status: Current
Address :
1515 Boyle Ave
ESCONDIDO CA 92027-4415
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Betancourt, Paul Jacob
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43691 Primary Status: Current
Address :
742 Baylor Ave
CHULA VISTA CA 91913-2002
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Gamboa, Andrew Peter
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43801 Primary Status: Current
Address :
2453 Pine Valley Gln
ESCONDIDO CA 92026-1439
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: MARSH, PAMELA ANN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 3829 Primary Status: Cancelled
Address :
14117 TRICIA ST
POWAY CA 92064
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Scott, Jenevieve Elizabeth
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 42981 Primary Status: Current
Address :
12155 tech center drive
POWAY CA 92064
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Ayers, Steven Nathaniel
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 42849 Primary Status: Current
Address :
13608 Pomerado Rd Apt 19
POWAY CA 92064-3522
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Huss, Madelyn Adele
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 42875 Primary Status: Delinquent
Address :
3003 Flora Rd
LOMPOC CA 93436-9438
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: PELLEGRINI-CONTI, LISA MARIA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6872 Primary Status: Current
Address :
10832 SCRIPPS RANCH BLVD
109
SAN DIEGO CA 92131
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: GONZALES, JULIETTE LYN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40728 Primary Status: Current
Address :
1900 Villa Del Dios Gln
ESCONDIDO CA 92029-5321
SAN DIEGO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Bailey, MICHELLE L
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40601 Primary Status: Current
Address :
38657 Clearbrook Dr
MURRIETA CA 92563-5884
RIVERSIDE COUNTY
