California State Board of Optometry

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: Costco Wholesale Corporation

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 70894 Primary Status: Current

Address :
5030 Hamner Ave
EASTVALE CA 91752
RIVERSIDE COUNTY

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License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: SEARS OPTICAL DEPT

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 2567 Primary Status: Cancelled

Address :
5261 ARLINGTON AVENUE
RIVERSIDE CA 92504
RIVERSIDE COUNTY

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License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: SEARS OPTICAL #1195

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7433 Primary Status: Cancelled

Address :
5261 ARLINGTON AVENUE
RIVERSIDE CA 92504
RIVERSIDE COUNTY

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License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: VISION CENTER II # 4107

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7086 Primary Status: Cancelled

Address :
8227 DAY CREEK BLVD # 100
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO COUNTY

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License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Contact Lens Dispenser

Name: MARLO, ANNA MARIA

License/Registration Type: Registered Contact Lens Dispenser

License Number: 8275 Primary Status: Current

Address :
10655 Lemon Ave Apt 1203
RANCHO CUCAMONGA CA 91737-6958
SAN BERNARDINO COUNTY

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