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Licensing details for: 40095

Name: PEREZ-RENTERIA, MIRIAM SUSESTT

License Type: Registered Spectacle Lens Dispenser

Primary Status: Current Primary Status Definition

Address of Record

4492 Camino De La Plz Ste 1725
SAN YSIDRO CA 92173-3071
SAN DIEGO county
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Issuance Date

April 8, 2014

Expiration Date

December 31, 2025

Current Date / Time

November 6, 2025
1:33:46 AM

License Relationships

RDO to Registered Spectacle Lens Dispenser

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE # 781

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7029 Primary Status: Current

Address :
1130 BROADWAY
CHULA VISTA CA 91910
SAN DIEGO COUNTY

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