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Licensing details for: 8111

Name: WAMBOLD, ANN MARIE

License Type: Registered Contact Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

3253 Buckeye Ct
PLACERVILLE CA 95667-8334
EL DORADO county
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Issuance Date

October 20, 2015

Expiration Date

July 31, 2021

Current Date / Time

November 6, 2025
7:35:12 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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