Business and Professions Code section 2564.74

(a)

Application for registration as a nonresident ophthalmic lens dispenser shall be made on forms prescribed by the board, accompanied by the fee prescribed by this article, and shall bear the signature of the individual, or individuals if a copartnership, or the president or secretary if a corporation, and shall contain the name or fictitious or assumed name, if applicable, under which the person proposes to do business, location of the business, registration number issued by the board, if applicable, and the designation of an agent for service of process in California.

(b)

The board shall be notified in writing within 30 days of any change of name or fictitious or assumed name, location of business, corporate officer, or agent of service.