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Licensing details for: 1560

Name: MODLIN, KAREN DENISE

License Type: Registered Contact Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

14442 CONEJO ST
VICTORVILLE CA 92392-7626
SAN BERNARDINO county
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Issuance Date

March 23, 2006

Expiration Date

September 30, 2011

Current Date / Time

November 5, 2025
9:25:45 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 #6619

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6734 Primary Status: Current

Address :
951 N MILLIKEN AVE
ONTARIO CA 91764-5008
SAN BERNARDINO COUNTY

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