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Licensing details for: 4994

Name: KHIEV, PAULINA

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

724A E 8th St
LONG BEACH CA 90813-4608
LOS ANGELES county
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Issuance Date

February 20, 2004

Expiration Date

November 30, 2019

Current Date / Time

November 7, 2025
5:0:25 PM

License Relationships

RDO to Registered Spectacle Lens Dispenser

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: WAL-MART #2636

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6904 Primary Status: Current

Address :
8230 TALBERT AVE
HUNTINGTON BEACH CA 92646
ORANGE COUNTY

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