California State Board of Optometry

Licensing details for: 40662

Name: SIFUENTES, ANGELA RUSSELL SCOTT

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

41145 Long Hollow Dr
COARSEGOLD CA 93614-9143
MADERA county
Map

Issuance Date

July 20, 2016

Expiration Date

July 31, 2018

Current Date / Time

November 5, 2025
10:16:8 AM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: SAM'S CLUB #4704

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6879 Primary Status: Current

Address :
7663 NO. BLACKSTONE AVE
FRESNO CA 93720
FRESNO COUNTY