California State Board of Optometry

Licensing details for: 4501

Name: HO-MONTENEGRO, KIM

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

2331 YORKSHIRE DR
ANTIOCH CA 94509
CONTRA COSTA county
Map

Issuance Date

August 15, 2000

Expiration Date

June 30, 2002

Current Date / Time

November 6, 2025
11:14:58 AM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6454 Primary Status: Current

Address :
4801 CENTRAL AVENUE
RICHMOND CA 94804
CONTRA COSTA COUNTY