California State Board of Optometry

Licensing details for: 40202

Name: BLAKE, STEPHANIE MICHELLE

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

300 W Lincoln Ave Spc 79
ORANGE CA 92865-1064
ORANGE county
Map

Issuance Date

September 18, 2014

Expiration Date

August 31, 2016

Current Date / Time

November 5, 2025
7:45:30 AM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: TARGET OPTICAL #1955

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7486 Primary Status: Current

Address :
11525 E SOUTH STREET
CERRITOS CA 90703
LOS ANGELES COUNTY