California State Board of Optometry
Licensing details for: 9104
Name: Sullivan, Kenneth Michael
License Type: Registered Contact Lens Dispenser
Primary Status: Current
Address of Record
3007 N Arrowhead Ave
SAN BERNARDINO CA 92405-2601
SAN BERNARDINO county
Map
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 CORPORATION
License/Registration Type: Registered Dispensing Ophthalmic Business
License Number: 6171 Primary Status: Current
Address :
3801 PELANDALE AVE
MODESTO CA 95356
STANISLAUS COUNTY
SLD Dispenser & CLD Dispenser
License/Registration Role: Registered Contact Lens Dispenser
Related Party Role: Registered Spectacle Lens Dispenser
Name: Sullivan, Kenneth Michael
License/Registration Type: Registered Spectacle Lens Dispenser
License Number: 43445 Primary Status: Current
Address :
3007 N Arrowhead Ave
SAN BERNARDINO CA 92405-2601
