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Licensing details for: 1370

Name: CHAMPLAIN, JAMES RUSSELL

License Type: Registered Contact Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

7123 PARISH WAY
CITRUS HEIGHTS CA 95621
SACRAMENTO county
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Issuance Date

May 5, 2004

Expiration Date

June 30, 2005

Current Date / Time

November 5, 2025
9:14:8 PM

License Relationships

RDO to Registered Contact Lens Dispenser

License/Registration Role: Registered Contact Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: SAM'S CLUB #4799

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6938 Primary Status: Current

Address :
7147 GREENBACK LANE
CITRUS HEIGHTS CA 95621
SACRAMENTO COUNTY

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