California State Board of Optometry

Licensing details for: 1089

Name: BUSTOS, LISA J

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

3530 DAMIEN AVE SP 53
LA VERNE CA 91750
LOS ANGELES county
Map

Issuance Date

January 7, 1988

Expiration Date

February 28, 1994

Current Date / Time

November 6, 2025
11:24:6 AM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE #1318

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6840 Primary Status: Current

Address :
2000 Market Place Dr
MONTEREY PARK CA 91755
LOS ANGELES COUNTY