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Licensing details for: 40634

Name: DOMINGUES, ANGELITA VILLANUEVA

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

181 Stone Creek Cir
SAINT JOHNS FL 32259-9106
ST. JOHNS county
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Issuance Date

June 14, 2016

Expiration Date

April 30, 2022

Current Date / Time

November 6, 2025
2:13:12 AM

License Relationships

RDO to Registered Spectacle Lens Dispenser

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: WAL-MART STORE #1697

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6997 Primary Status: Current

Address :
8465 ELK GROVE BLVD
ELK GROVE CA 95758
SACRAMENTO COUNTY

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