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Licensing details for: 2306

Name: PETRAMALO, THEODORE ANTHONY

License Type: Registered Contact Lens Dispenser

Primary Status: Current Primary Status Definition

Address of Record

1153 Katey Ln
SIMI VALLEY CA 93063-4621
VENTURA county
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Issuance Date

June 25, 2013

Expiration Date

May 31, 2027

Current Date / Time

November 6, 2025
11:12:2 PM

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 #128

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 6165 Primary Status: Current

Address :
2660 PARK CENTER DR
SIMI VALLEY CA 93065
VENTURA COUNTY

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