California State Board of Optometry

Licensing details for: 6791

Name: SRISIANGBOON, JILLIAN

License Type: Registered Spectacle Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

3441 ARROYO SECO AVENUE
LOS ANGELES CA 90065
LOS ANGELES county
Map

Issuance Date

April 29, 2013

Expiration Date

October 31, 2014

Current Date / Time

November 6, 2025
7:48:58 PM

License/Registration Role: Registered Spectacle Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE #677

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6760 Primary Status: Current

Address :
1051 BURBANK BLVD
BURBANK CA 91506
LOS ANGELES COUNTY