California State Board of Optometry

Licensing details for: 41720

Name: Portman, Nida M

License Type: Registered Spectacle Lens Dispenser

Primary Status: Delinquent Primary Status Definition

Address of Record

14714 Tupper St
PANORAMA CITY CA 91402-1245
LOS ANGELES county
Map

Issuance Date

August 9, 2019

Expiration Date

August 31, 2023

Current Date / Time

November 6, 2025
10:46:4 AM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE #1071

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7518 Primary Status: Current

Address :
13350 Paxton St
PACOIMA CA 91331-2339
LOS ANGELES COUNTY