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Licensing details for: 1346

Name: JACKSON, NATALIE ANN

License Type: Registered Contact Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

8590 DUFFERIN AVE
RIVERSIDE CA 92504
RIVERSIDE county
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Issuance Date

February 20, 2004

Expiration Date

June 30, 2017

Current Date / Time

November 6, 2025
12:26:58 AM

License Relationships

RDO to Registered Contact Lens Dispenser

License/Registration Role: Registered Contact Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE #455

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6839 Primary Status: Current

Address :
12700 DAY ST
MORENO VALLEY CA 92553
RIVERSIDE COUNTY

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