California State Board of Optometry
Licensing details for: 1432
Name: MATHENY, JUSTIN BRYAN
License Type: Registered Contact Lens Dispenser
Primary Status: Cancelled

Address of Record
P O BOX 473
SOULSBYVILLE CA 95372
TUOLUMNE county
Map
License Relationships
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Contact Lens Dispenser
Related Party Role: Registered Dispensing Ophthalmic Business
Name: NATIONAL VISION EYECARE CENTER #2030
License/Registration Type: Registered Dispensing Ophthalmic Business
License Number: 5836 Primary Status: Cancelled
Address :
1101 SANGUINETTI RD
SONORA CA 95370
TUOLUMNE COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Contact Lens Dispenser
Related Party Role: Registered Dispensing Ophthalmic Business
Name: WAL-MART VISION CENTER #1983
License/Registration Type: Registered Dispensing Ophthalmic Business
License Number: 7136 Primary Status: Current
Address :
3690 Mitchell Rd
CERES CA 95307-5022
STANISLAUS COUNTY
RDO to Registered Contact Lens Dispenser
License/Registration Role: Registered Contact Lens Dispenser
Related Party Role: Registered Dispensing Ophthalmic Business
Name: WAL-MART VISION CENTER 2030
License/Registration Type: Registered Dispensing Ophthalmic Business
License Number: 7160 Primary Status: Current
Address :
1101 SANGUINETTI ROAD
SONORA CA 95370
TUOLUMNE COUNTY
SLD Dispenser & CLD Dispenser
License/Registration Role: Registered Contact Lens Dispenser
Related Party Role: Registered Spectacle Lens Dispenser
Name: MATHENY, JUSTIN BRYAN
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 5192 Primary Status: Cancelled
Address :
16995 COLUMBIA RIVER
SONORA CA 95370
TUOLUMNE COUNTY



