Kenneth Kervin Supan Talavera
ActiveCalifornia license 41009
License
- Licensed by
- California State Board of Optometry
- License number
- 41009
- Status
- Active (Current)
- First issued
- October 16, 2017
- Expires
- April 30, 2027
- License holder
- Kenneth Kervin Supan Talavera
- Entity type
- Individual
Classifications
- Registered Spectacle Lens Dispenser Vision & Hearing
More from the license record
- License type code
- 4206
Contact
17237 Via Estrella
San Lorenzo, CA 94580-2705
San Lorenzo, CA 94580-2705