California State Board of Optometry
Licensing details for: 7189
Name: COSTCO WHOLESALE 643
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
4900 PANAMA LANE
BAKERSFIELD CA 93313
KERN 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: HADDAD, JACKLIN NIDAL
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1917 Primary Status: Current
Address :
17226 Ceredo Pl
GRANADA HILLS CA 91344-1606
LOS ANGELES COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: GONZALEZ, CASSANDRA ANGELLE
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2246 Primary Status: Cancelled
Address :
APT A
2921 BROOKSIDE DR
BAKERSFIELD CA 93311
KERN COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Wallace, Denise Michelle
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9151 Primary Status: Current
Address :
4900 Panama Ln
BAKERSFIELD CA 93313-3479
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: JOHNSON, BRANNON ERWIN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8285 Primary Status: Delinquent
Address :
3135 Alameda St
Unit 20
MEDFORD OR 97504-8646
JACKSON COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: HORCHER, JOYCE LYNN
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1950 Primary Status: Current
Address :
PO BOX 305
KEENE CA 93531
KERN COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Nicasio, Stacey
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8833 Primary Status: Current
Address :
4004 Ocean Breeze Ave
BAKERSFIELD CA 93313-4445
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: SMITH, JIMMY RAY
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2063 Primary Status: Current
Address :
12400 VERDELHO AVENUE
BAKERSFIELD CA 93312
KERN COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: GEARHART, JOHNNY D
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2024 Primary Status: Current
Address :
4900 Panama Ln
BAKERSFIELD CA 93313-3479
KERN COUNTY
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: arellano, amabely
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9154 Primary Status: Current
Address :
4900 Panama Ln
BAKERSFIELD CA 93313-3479
KERN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Aguilera, Jennifer
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 41889 Primary Status: Current
Address :
3708 Grand Prix Pl
BAKERSFIELD CA 93306-8385
KERN 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: JOHNSON, BRANNON ERWIN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40645 Primary Status: Delinquent
Address :
4416 Mattnick Dr
BAKERSFIELD CA 93313-3917
KERN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: GONZALEZ, CASSANDRA ANGELLE
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6695 Primary Status: Cancelled
Address :
APT A
2921 BROOKSIDE DR
BAKERSFIELD CA 93311
KERN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: arellano, amabely
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43532 Primary Status: Current
Address :
4900 Panama Ln
BAKERSFIELD CA 93313-3479
KERN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: SMITH, JIMMY RAY
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6253 Primary Status: Current
Address :
12400 VERDELHO AVENUE
BAKERSFIELD CA 93312
KERN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Wallace, Denise Michelle
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43398 Primary Status: Current
Address :
913 Halterio Ct
BAKERSFIELD CA 93309-2734
KERN COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: HADDAD, JACKLIN NIDAL
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5862 Primary Status: Current
Address :
17226 Ceredo Pl
GRANADA HILLS CA 91344-1606
LOS ANGELES COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: HORCHER, JOYCE LYNN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5789 Primary Status: Current
Address :
PO BOX 305
KEENE CA 95351
KERN COUNTY
