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Licensing details for: 2135

Name: BORNEA, MIRALLY P

License Type: Registered Contact Lens Dispenser

Primary Status: Current Primary Status Definition

Address of Record

1438 NORVELLA STREET
SAN JOSE CA 95122
SANTA CLARA county
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Issuance Date

July 11, 2011

Expiration Date

May 31, 2027

Current Date / Time

November 6, 2025
8:6:48 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 Corporation

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 71279 Primary Status: Current

Address :
350 Newpark Mall
NEWARK CA 94560-5201
ALAMEDA COUNTY

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RDO to Registered Contact Lens Dispenser

License/Registration Role: Registered Contact Lens Dispenser

Related Party Role: Registered Dispensing Ophthalmic Business

Name: COSTCO WHOLESALE # 778

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7066 Primary Status: Current

Address :
43621 PACIFIC COMMONS BLVD
FREMONT CA 94538
ALAMEDA COUNTY

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