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Licensing details for: 2149

Name: CLARK, CLAYTON PAUL

License Type: Registered Contact Lens Dispenser

Primary Status: Current Primary Status Definition

Address of Record

4491 Palencia Pl
EL DORADO HILLS CA 95762-6745
EL DORADO county
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Issuance Date

November 1, 2011

Expiration Date

June 30, 2027

Current Date / Time

November 6, 2025
7:41:55 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 #765

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6899 Primary Status: Current

Address :
1800 CAVITT CT
FOLSOM CA 95630
SACRAMENTO COUNTY

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