California State Board of Optometry
Licensing details for: 70701
Name: WALMART VISION CENTER #1789
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
1601 S Lower Sacramento Rd
LODI CA 95242-9571
SAN JOAQUIN 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: Clark, Leslie Ann
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9165 Primary Status: Current
Address :
5031 Quonset Dr
SACRAMENTO CA 95820
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: SISK, GREGORY ALLEN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1502 Primary Status: Delinquent
Address :
1311 W Century Blvd Apt 65
LODI CA 95242-4529
SAN JOAQUIN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Marquez, Teresa Anne
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43881 Primary Status: Current
Address :
5915 Riverbank Cir
STOCKTON CA 95219-2521
SAN JOAQUIN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: SISK, GREGORY ALLEN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5330 Primary Status: Delinquent
Address :
1311 W Century Blvd Apt 65
LODI CA 95242-4529
SAN JOAQUIN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: MEJIA, LEANNA KIUNKE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40079 Primary Status: Current
Address :
10250 Pistachio Way
SACRAMENTO CA 95827-2473
SACRAMENTO COUNTY
