California State Board of Optometry

Licensing details for: 5015

Name: BERG, DENNIS KEVIN

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

4561 WANDERING WAY
CAMINO CA 95709
EL DORADO county
Map

Issuance Date

March 18, 2004

Expiration Date

October 31, 2015

Current Date / Time

November 5, 2025
10:54:26 PM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: WAL MART STORE # 2418

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6959 Primary Status: Current

Address :
4300 MISSOURI FLAT RD
PLACERVILLE CA 95667
EL DORADO COUNTY