California State Board of Optometry
Licensing details for: 40801
Name: GUTIERREZ FUENTES, JUANA
License Type: Registered Spectacle Lens Dispenser
Primary Status: Cancelled
Previous Names: FUENTES, JUANA GUTIERREZ
Address of Record
4214 Shellicia Cir
RIVERSIDE CA 92509-0732
RIVERSIDE county
Map
License Relationships
RDO to Registered Spectacle Lens Dispenser
License/Registration Role: Registered Spectacle Lens Dispenser
Related Party Role: Registered Dispensing Ophthalmic Business
Name: COSTCO # 1001
License/Registration Type: Registered Dispensing Ophthalmic Business
License Number: 7265 Primary Status: Current
Address :
2700 PARK AVENUE
TUSTIN CA 92782
ORANGE COUNTY
SLD Dispenser & CLD Dispenser
License/Registration Role: Registered Spectacle Lens Dispenser
Related Party Role: Registered Contact Lens Dispenser
Name: GUTIERREZ FUENTES, JUANA
License/Registration Type: Registered Contact Lens Dispenser
License Number: 8372 Primary Status: Cancelled
Address :
4214 Shellicia Cir.
RIVERSIDE CA 92509
RIVERSIDE COUNTY
