California State Board of Optometry

Licensing details for: 6042

Name: FERNANDEZ, MIRIAM

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

2915 S Ridgeley Dr
LOS ANGELES CA 90016-3717
LOS ANGELES county
Map

Issuance Date

August 10, 2009

Expiration Date

January 31, 2012

Current Date / Time

November 6, 2025
6:59:3 AM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE #479

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6455 Primary Status: Current

Address :
13463 WASHINGTON BOULEVARD
MARINA DEL REY CA 90292
LOS ANGELES COUNTY