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Licensing details for: 8534

Name: Polus, Mariam

License Type: Registered Contact Lens Dispenser

Primary Status: Cancelled Primary Status Definition

Address of Record

255 s 2nd st
unit 20
EL CAJON CA 92019
SAN DIEGO county
Map

Issuance Date

October 2, 2019

Expiration Date

October 31, 2021

Current Date / Time

November 5, 2025
8:57:34 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 #488

License/Registration Type: Registered Dispensing Ophthalmic Business

License Number: 3839 Primary Status: Current

Address :
2345 FENTON PARKWAY
SAN DIEGO CA 92108
SAN DIEGO COUNTY

Map

SLD Dispenser & CLD Dispenser

License/Registration Role: Registered Contact Lens Dispenser

Related Party Role: Registered Spectacle Lens Dispenser

Name: Polus, Mariam

License/Registration Type: Registered Spectacle Lens Dispenser

License Number: 41784 Primary Status: Cancelled

Address :
255 s 2nd st
unit 20
EL CAJON CA 92019
SAN DIEGO COUNTY

Map

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