California State Board of Optometry

Licensing details for: 5021

Name: FERNANDEZ, MICHAEL R

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Previous Names: FERNANDEZ, MICHAEL REYNADO

Address of Record

3806 WEST BLVD
LOS ANGELES CA 90008
LOS ANGELES county
Map

Issuance Date

March 22, 2004

Expiration Date

September 30, 2005

Current Date / Time

November 6, 2025
10:1:27 AM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE # 671

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 3998 Primary Status: Current

Address :
14501 HINDRY AVE
HAWTHORNE CA 90250
LOS ANGELES COUNTY