California State Board of Optometry
Licensing details for: 40806
Name: MATA, ALFREDO DEJESUS
License Type: Registered Spectacle Lens Dispenser
Primary Status: Cancelled

Address of Record
4609 Hollyline Ave
SANTA ANA CA 92703-1524
ORANGE 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



