California State Board of Optometry
Licensing details for: 7307
Name: COSTCO WHOLESALE #1004
License Type: Registered Dispensing Ophthalmic Business
Primary Status: Current
Address of Record
1709 AUTOMATION PARKWAY
SAN JOSE CA 95131
SANTA CLARA 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: Alonso Ureno, Maria del Carmen
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9312 Primary Status: Current
Address :
5451 Tyler Pl
FREMONT CA 94538-1035
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: PAIYOU, WENDY H.
License/Registration Type: Registered Contact Lens Dispenser
License Number: 1651 Primary Status: Cancelled
Address :
514 INDEPENDENCE DRIVE
SAN JOSE CA 95111
SANTA CLARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Favela, Alexa Anne
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8298 Primary Status: Current
Address :
1786 Deer Creek Ct
SAN JOSE CA 95148-1402
SANTA CLARA 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: MEDINA, FLAVIA CRISTINA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8254 Primary Status: Current
Address :
6898 Raleigh Rd
SAN JOSE CA 95119-1730
SANTA CLARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: SHIM, DEBORAH EUN-KYUNG
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8118 Primary Status: Delinquent
Address :
17053 Pistache Dr
MORGAN HILL CA 95037-7246
SANTA CLARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Shambe, Alaase
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9058 Primary Status: Current
Address :
854 N 14th st
SAN JOSE CA 95112
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Gilmore, Alexandra Jo
License/Registration Type: Registered Contact Lens Dispenser
License Number: 7983 Primary Status: Cancelled
Address :
3955 Seven Trees Blvd Apt 133
SAN JOSE CA 95111-3492
SANTA CLARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Belk, Michael
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9237 Primary Status: Current
Address :
1709 Automation Pkwy
SAN JOSE CA 95131-1866
SANTA CLARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: TREDER, ROBERT NATHANIEL
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2009 Primary Status: Cancelled
Address :
2644 BARKLEY AVENUE
SANTA CLARA CA 95051
SANTA CLARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: Jolly, Bryan
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9057 Primary Status: Current
Address :
1709 Automation Pkwy
SAN JOSE CA 95131-1866
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: DE VERA, JERRY ABARCA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 9206 Primary Status: Current
Address :
20350 Stevens Creek Blvd Apt 518
CUPERTINO CA 95014-2250
SANTA CLARA COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Contact Lens Dispenser
Name: REYES, CYNTHIA TALAVERA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 2044 Primary Status: Current
Address :
340 Carnegie Dr
MILPITAS CA 95035-5913
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: LEMOS, CATHERINE ELIZABETH
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40842 Primary Status: Cancelled
Address :
306 Scenic Dr
LA HONDA CA 94020
SAN MATEO COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: MEDINA, FLAVIA CRISTINA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40980 Primary Status: Current
Address :
6898 Raleigh Rd
SAN JOSE CA 95119-1730
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Alonso Ureno, Maria del Carmen
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43740 Primary Status: Current
Address :
5451 Tyler Pl
FREMONT CA 94538-1035
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: PAIYOU, WENDY H.
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5574 Primary Status: Current
Address :
514 INDEPENDENCE DRIVE
SAN JOSE CA 95111
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: LEONG, SANDI
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40688 Primary Status: Current
Address :
34868 Rumford Ter
UNION CITY CA 94587-7900
ALAMEDA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Jolly, Bryan
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43346 Primary Status: Current
Address :
1709 Automation Pkwy
SAN JOSE CA 95131-1866
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: RAMOS, DAVID ALLEN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40383 Primary Status: Cancelled
Address :
1324 Arnold Ave
SAN JOSE CA 95110-1403
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Smith, Roxanne Margaret
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 41100 Primary Status: Delinquent
Address :
1425 Tourney Dr
SAN JOSE CA 95131-2629
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: PACKHAM, COLIN ANDREW
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40211 Primary Status: Cancelled
Address :
63 Muirfield Ct
SAN JOSE CA 95116-2652
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: TREDER, ROBERT NATHANIEL
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6104 Primary Status: Cancelled
Address :
2644 BARKLEY AVENUE
SANTA CLARA CA 95051
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Rafael, Jennifer Paola
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43543 Primary Status: Current
Address :
2391 Dobern Ave
SAN JOSE CA 95116-3719
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Shambe, Alaase
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 42824 Primary Status: Current
Address :
854 N 14th St
SAN JOSE CA 95112-1517
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Crummie, Devante
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 41353 Primary Status: Current
Address :
1602 Briarpoint Dr
SAN JOSE CA 95131-3101
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Belk, Michael
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43688 Primary Status: Current
Address :
780 Saratoga Ave Apt S303
SAN JOSE CA 95129-2449
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: REYES, CYNTHIA TALAVERA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 6165 Primary Status: Current
Address :
340 Carnegie Dr
MILPITAS CA 95035-5913
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: DE VERA, JERRY ABARCA
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43369 Primary Status: Current
Address :
4340 Crescendo Ave
SAN JOSE CA 95136-2115
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: Favela, Alexa Anne
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 41103 Primary Status: Current
Address :
1786 Deer Creek Ct
SAN JOSE CA 95148-1402
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: SHIM, DEBORAH EUN-KYUNG
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 40492 Primary Status: Delinquent
Address :
17053 Pistache Dr
MORGAN HILL CA 95037-7246
SANTA CLARA COUNTY
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Dispensing Ophthalmic Business
Related Party Role: Registered Spectacle Lens Dispenser
Name: RAMOS, DAVID ALLEN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5458 Primary Status: Current
Address :
1324 Arnold Ave
SAN JOSE CA 95110-1403
SANTA CLARA COUNTY
