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Licensing details for: 1636

Name: BENTON, ANTHONY S

License Type: Registered Contact Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

13522 CHADRON AVE #218
HAWTHORNE CA 90250
LOS ANGELES county
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Issuance Date

October 16, 2006

Expiration Date

October 31, 2008

Current Date / Time

November 5, 2025
10:32:32 AM

License Relationships

RDO to Registered Contact Lens Dispenser

License/Registration Role: Registered Contact Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: WALMART VISION CENTER 2110

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7205 Primary Status: Current

Address :
14501 LAKEWOOD BLVD
PARAMOUNT CA 90723
LOS ANGELES COUNTY

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