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Licensing details for: 8372

Name: GUTIERREZ FUENTES, JUANA

License Type: Registered Contact Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Previous Names: FUENTES, JUANA GUTIERREZ

Address of Record

4214 Shellicia Cir.
RIVERSIDE CA 92509
RIVERSIDE county
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Issuance Date

August 20, 2018

Expiration Date

August 31, 2022

Current Date / Time

November 5, 2025
9:15:53 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 # 1001

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 7265 Primary Status: Current

Address :
2700 PARK AVENUE
TUSTIN CA 92782
ORANGE COUNTY

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SLD Dispenser & CLD Dispenser

License/Registration Role: Registered Contact Lens Dispenser

Related Party Role: Registered Spectacle Lens Dispenser

Name: GUTIERREZ FUENTES, JUANA

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 40801 Primary Status: Cancelled

Address :
4214 Shellicia Cir
RIVERSIDE CA 92509-0732
RIVERSIDE COUNTY

Map

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