California State Board of Optometry

Licensing details for: 40879

Name: MATA, TIFFANY MARIE

License Type: Registered Spectacle Lens Dispenser

Primary Status: Delinquent Primary Status Definition

Address of Record

132 Wilkie Way Apt A
EL CAJON CA 92021-4093
SAN DIEGO county
Map

Issuance Date

April 11, 2017

Expiration Date

February 28, 2023

Current Date / Time

November 7, 2025
4:41:45 AM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: WAL-MART STORE # 3524

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7019 Primary Status: Cancelled

Address :
605 FLETCHER PKWY
EL CAJON CA 92020
SAN DIEGO COUNTY