California State Board of Optometry
Licensing details for: 7095
Name: WAL-MART VISION CENTER #1899
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
6250 VALLEY SPRINGS PKWY
RIVERSIDE CA 92507
RIVERSIDE 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: ZEPEDA, JESUS RAMON
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8308 Primary Status: Current
Address :
24601 Wisteria Lane
MORENO VALLEY CA 92557
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: GRAVES, ANTHONY WAYNE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1052 Primary Status: Current
Address :
27815 Via Sonata
MORENO VALLEY CA 92555-5854
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: KATZ, JEROME H
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1815 Primary Status: Current
Address :
600 CENTRAL AVE # 200
RIVERSIDE CA 92507
RIVERSIDE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: BEANBLOSSOM, ERIKA DENISE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8061 Primary Status: Delinquent
Address :
PO Box 6990
BIG BEAR LAKE CA 92315-6990
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: GRAVES, ANTHONY WAYNE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 2801 Primary Status: Current
Address :
27815 Via Sonata
MORENO VALLEY CA 92555-5854
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: JIMENEZ, SARAH FELICIA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5328 Primary Status: Cancelled
Address :
12785 FREDERICK ST #203
MORENO VALLEY CA 92553
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: BEANBLOSSOM, ERIKA DENISE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40313 Primary Status: Cancelled
Address :
PO Box 6990
BIG BEAR LAKE CA 92315-6990
SAN BERNARDINO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: ZEPEDA, JESUS RAMON
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40549 Primary Status: Current
Address :
24601 Wisteria Ln
MORENO VALLEY CA 92557-4105
RIVERSIDE COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: KATZ, JEROME H
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5721 Primary Status: Current
Address :
600 CENTRAL AVE 200
RIVERSIDE CA 92507
RIVERSIDE COUNTY
