GEORGIA COMPOSITE MEDICAL BOARD MINUTES JULY 10, 2014 · GEORGIA COMPOSITE MEDICAL BOARD MINUTES JULY 10, 2014 3 15. Dana Thomas emailed wanting to clarify that a medical assistant

GEORGIA COMPOSITE MEDICAL BOARD MINUTES

JULY 10, 2014

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The Georgia Composite Medical Board (GCMB) held its regular meeting on July 10, 2014 at 2 Peachtree St., NW 36th Floor, Atlanta, GA 30303 to consider Medical Board matters. Board members in attendance on Thursday, July 10, 2014 were:

David Retterbush, MD, Chairperson Alice A. House, MD, Vice Chairperson John S. Antalis, MD William Butler, MD E. Daniel Deloach, MD Charmaine Faucher, PA-C, Ex-Officio Board Member Alexander S. Gross, MD Jeffery Grossman, M.D. Jane “Cami” McGarity, Consumer Member B. K. Mohan, MD Trey Powell, M.D. Ronnie Wallace, Consumer Member Richard Weil, MD Charles White, DO

Board members absent on Thursday, July 10, 2014 were:

William S. Sightler, DO Representatives from the Attorney General’s Office:

Amelia Baker, Senior Assistant Attorney General Wylencia H. Monroe, Senior Assistant Attorney General D. Williams-McNeely, Assistant Attorney General David Stubins, Assistant Attorney General

CALL TO ORDER Dr. Retterbush called the meeting of the Georgia Composite Medical Board to order at 7:30 a.m. AGENDA Dr. Butler submitted a motion, seconded by Dr. Deloach, to approve the agenda of the July 10, 2014 meeting. The motion carried unanimously. MINUTES Dr. Deloach submitted a motion, seconded by Dr. Gross, to approve the minutes of the June 5-6, 2014 meeting with amendments. The motion carried unanimously. Dr. Weil submitted a motion, seconded by Dr. Butler, to approve the minutes of the June 17, 2014 teleconference meeting.


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Dr. Retterbush and Ms Hughes recognized Phyllis White for her sixteen years of service with the State. Ms. Hughes introduced Jeffery Grossman, M.D., new Board Member, to the Board. EXECUTIVE DIRECTOR’S REPORT LaSharn Hughes, Executive Director, presented the following information for the Board’s review. Dr. Deloach submitted a motion, seconded by Dr. Mohan, to accept the report. The motion carried unanimously. The Board took the following actions:

1. C.L. Nuss asked questions concerning who has authority to prescribe the ElectroMedical Wellness Pro Machine to patients. The Board responded this must be prescribed by a licensed physician.

2. Brian Looby with McGuire Woods Consulting Public Affairs Solutions asks whether Teledoc violates the Board’s telemedicine. The Board advised to refer to the laws and rules.

3. Brian Looby emailed with a question – can medical assistants enter physician orders in a HER? Board replied they may do so, but the physician must sign.

4. Dr. Paul McCluskey asked can a physician be exempt from licensure for training course. Physician must have a license.

5. Affiliated Monitors, Inc. asked the Board to consider inviting them to a Board meeting for a presentation.. The Board approved the request.

6. Carol Clothier with the American Board of Medical Specialties requested a meeting with the Board to discuss Maintenance of Certification. The Board requested additional information.

7. Robert Hull requested if his old orders can be removed from the Board’s website. Board advised no.

8. Reviewed an article entitled “The Partner ship for Safe Telemedicine.” For information only.

9. Rajesh Patel, M.D. had questions. The Board reviewed his letter and advised this is institution questions and he should refer to the by laws of the institution.

10. Regarding an article entitled “Missouri legislation would allow assistant doctors.” Board would be apposed to this legislation in Georgia.

Articles Reviewed for Information only;

11. “Experts Discuss 4 Major Barriers to Telehealth Adoption. 12. “Medical Draft Plan to ease Path to Out of State and Online Treatment.” 13. “Decline in Drug Overdose Deaths After State Policy Change.” 14. Letter from the State Board if Workers Compensation – regarding drug screening. Board

responded there should be a complete screening.


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15. Dana Thomas emailed wanting to clarify that a medical assistant can do B12 shots. Board advised yes as in the Laws and Rules.

Dr. White motioned to go into closed Session to discuss investigative matters. Dr. Weil seconded the motion and it carried unanimously. Dr. Retterbush declared the meeting in Open Session LAW ENFORCEMENT ACTION REPORT Emmalie Kirkland, Acting Director of Investigations, presented the Law Enforcement Action Report for the Board’s review. Dr. Deloach submitted a motion, seconded by Dr. Gross, to accept the report. The motion carried unanimously. The Board took the following actions:

1. Request from Indiana, Office of Attorney General, Licensing Enforcement & Homeowner

Protection Unit requests certified copies of disciplinary information regarding investigative file 20140684. Board denied request.

2. Request from Indiana, Office of Attorney General, and Licensing Enforcement &

Homeowner Protection Unit for certified copies of disciplinary information regarding Investigative files 20131631, 20101001, 2050912. Board denied request.


Protection Unit for certified copies of disciplinary information regarding investigative file 20130093. Board approved to share information.


Protection Unit for certified copies of disciplinary information regarding investigative file 20140703. Board approved to share information.

5. Kevin J. Fee, Esquire has submitted a request for the Board to release R.E. application file

and/or portions thereof. Board denied request. 6. Request from Sirce Owen, Assistant Chief Counsel of Immigration & Customs Enforcement

(Atlanta Office) for the Board to release J.A.M. application file, and information that he may have submitted to the Board related to his immigration status or country of citizenship.

Board approved request. 7. North Little Rock Police Department requested information related to application for S.R.

Board denied request. 8. Respondent in Investigative File 20021258 provided a release and requested that the Board

release “medical records and judgment” to current provider. Board tabled request.


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9. Lawrence Edward Eppelbaum, M.D. – Board ratified acceptance of Voluntary Surrender. 10. William Mayberry, M.D. – Accepted Agreement not to Practice. 11. Laurin Smith, M.D. – Accept Inactive Status Application and waive fee. 12. Kush Kumar, M.D. – Requested to reopen his investigative file. Board denied request.

13. Susan Mildred Harding, MD - Approved amended Consent Order. 14. Warren M. Weber, M.D. – Approved Consent Order 15. Forsyth County Sheriff’s Office, requested that the Board share investigative information

regarding E.W.H. Board approved request. 16. Joshua Harris, M.D. – Approve Consent Order, or application for inactive status upon

receipt. If not received in seven days issue Order of summary Suspension.

APPEARANCE BEFORE THE BOARD Dr. Seth Pope requested an appearance before the Board for denial of licensure reinstatement. Dr. Pope gave the Board information concerning steps he had taken toward his reinstatement, and asked for guidance as to what he needs to do to have his licensure reinstated. The Board members asked questions. Dr. White motioned to go into Closed Session to discuss investigative matters. Dr. Powell seconded the motion and it carried unanimously. Dr. Retterbush declared Open Session. Dr Butler motioned to uphold denial of Dr. Pope’s reinstatement, and inform him of pathway that he would need before reapplying. Dr. Deloach seconded the motion and it carried unanimously.

RECONVENED Dr. Butler moved to go into Closed Session to conduct Investigative Interviews. Dr. White seconded, the motion and it carried unanimously. Dr. Retterbush then declared the meeting would be open session upon completion of the investigative interviews for the purpose of holding committee meetings.

CALL TO ORDER Dr. Retterbush called the meeting of the Georgia Composite Medical Board to order at 2:30 p.m..


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ADVISORY COMMITTEE REPORTS ACUPUNCTURE ADVISORY COMMITTEE Dr. Butler presented the report of the Acupuncture Advisory Committee as a motion. Dr. Powell seconded the motion, and it carried unanimously. The Board took the following actions: Accepted Quarterly Reports:

Jennifer Myers Rebecca Porter

Approved application for Initial Licensure: Byeong-Su Hyun

Other Business: Accepted as information - the list of limited licensees and supervisors

LASER ADVISORY COMMITTEE Dr. Gross presented the Laser Advisory Committee as a motion. Dr. Deloach seconded the motion, and it carried unanimously. The Board took the following actions: 1. The Board approved the Committee’s request to review the draft laser checklists and application

and provide changes.

2. The Board agreed that once changes are compiled, a special conference call will be held with the Attorney General’s Office to review the application for additional changes or approval.

PHYSICIAN LICENSING COMMITTEE Dr. House presented the report of the Physician Licensing Committee as a motion. Dr. Powell seconded the motion, and it carried unanimously. The Board took the following actions: Interviews:

1. Saadatmand, Babak- Approved licensure 2. Sams, John – Approved Licensure 3. Paris, Ray – Approved licensure

Tabled Applications:

1. J.P. 2. B.B.

. Approved Waiver request:

1. Maduoma, Christian—Approve Request for Waiver Petition Rule 360-2-.02(5) 2. Pinkey, Broderick-Approve Request for Petition to Waive Rule 360-2-02


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3. Awd, Rame--Approve Request to waive Rule 360-2-.01(f) and Approve Request to waive Rule 360-2-.02(5).

4. Espinosa, Jose—Approve Request to waive Rule 360-2-.01 (f) re: waive official medical school transcript

Approved Residency Training Permits:

Waterman, Jennifer Kisselberg, James Boren, Kyle Green, Brandon Ghattas, Paul Butler, Leroy Barton, Darren

Approved Reinstatement Applications:

33802 Branson, Bernard MD 21654 Brownstein, Richard MD 12440 Cohen, Jack MD 54997 Dobak, William DO 36724 Ebba, Ebba MD 66291 Fowler, Donald MD 57366 Fynes, Margaret MD 42046 Gitter, Morris MD 23480 Miller, Charles MD 55862 Mohsin, Intikhab MD 17106 Kessler, Michael MD 50541 Moore, Keith MD 4673 Vasconez, Luis MD 35336 Avi, Xavier MD 27250S Mith, Joseph R MD

Other Business:

1. Wang, Ya-Ying - Deny Request for USMLE sponsorship 2. Smith, Ronald -Deny Request for USMLE sponsorship 3. Question: Does the Board require a notarized copy of a medical school diploma from an

international medical school graduate if they have provided a verifiable copy of their transcript? Answer: Yes

4. Rondon Vidal, Michael—Approved one additional month to complete application and present to the board by the August 7th-8th Meeting.

5. P.K. – Advised will need clinical skills assessment. 6. Laborde, David – Approved request for Administrative License 7. R.R.—Complete CPEP recommended remediation & complete CSA before the board will

reconsider 8. D.T. – Approve Request to cease monitoring reports.


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Approved Applicants for Licensure:

72304 OHENE ADJEI, RITA MD 72305 OBASI, IKENNA EREM MD 72306 JONES, ERICA MD 72307 KASIAH, FATIMA ELIZABETH MD 72308 NELSON, ROGER F MD 72309 KERR, PAUL C MD 72310 JIN, QUANRI MD 72311 MADUOMA, CHRISTIAN MD 72312 KAKARALA, PRAMOD MD 72313 ORTIZ-POMALES, YAN T MD 72314 HINRICHS, BENJAMIN HEYE MD 72315 HARRIS, KATHRYN E MD 72316 IP, ANDREW MD 72317 MCKINNON, ELIZABETH ANN MD 72318 MANAHAN, KELLY MD 72319 MCELROY, SAMUEL DAVID PATRICK MD 72320 KILLELEA, ALISON GIULIA MD 72321 LEE, GOO MD 72322 KHAN, SAJID MD 72323 MYERS, TERESA ANN MD 72324 KRAHNKE, JASON STANLEY DO 72325 HUTCHINSON, HANK L MD 72326 NELKOVSKI, LIDIA MD 72327 JASPER, ALAN LAWRENCE RUSSELL DO 72328 HIGHSTEAD, RICHARD GRANT MD 72329 MALCOM, CHRISTOPHER JAMES MD 72330 HAMMONDS, KARON NACHELLE MD 72331 JAGODZINSKI, JASON EDWARD MD 72332 LEON - HERNANDEZ, ANGELA PATRICIA MD 72333 MILLS, KYLE CHARLES MD 72334 JOHNSON, ROBERT PAUL MD 72335 OLSEN, JESSICA MD 72336 NEAL, DURWOOD EARNEST JR MD 72337 KNEER, LEE MICHAEL MD 72338 MOMA, CLETUS TANWI MD 72339 KALARICKAL, PHILIP LUKE MD 72340 MATHEW, KAVITHA ANNA MD 72341 MARINCA, DEBORAH MD 72342 JENSEN, SHARONE MD 72343 KOCH, GREGORY DANIEL MD 72344 KAMEL, IHAB ROUSHDY MD 72345 MEESALA, YASODA MD


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72346 KIERAN, OWEN ROBERT DO 72347 LUCAS, MANDY MD 72348 HIRO, MATTHEW EDWARD MD 72349 HERR, RAYMOND KARL MD 72350 KHAN, SHEEMA MD 72351 NYSHADHAM, SOUMYA MD 72352 HALL, PATRICIA FAULKNER MD 72353 HAW, JEEHEA SONYA MD 72354 KASTELLO, ANDREW DOUGLAS MD 72355 KOTWAL, NEVILLE HOMI MD 72356 HOFFMANN, JOHN F MD 72357 HOLTON, JENNIFER ELIZABETH MD 72358 NWOBU, CHINYELU OBIAMAKA MD 72359 KOTLYAR, SIMON MD 72360 KRUSZEWSKI, PATRICE GENEVIEVE DO 72361 HABET, GISELLE K MD 72362 MENDEL, JUSTIN BRETT MD 72363 MOURAD, WALEED FOUAD ELSAYED MD 72364 LIEBERMAN, CAROLE ILENE MD 72365 HART, CRAIG FRANKLIN MD 72366 HARROM, HEATH MD 72367 NAUJOKAS, AGNE DO 72368 ONUEGBU, PATRICIA CHINYERE MD 72369 LAWRENCE, MELISSA MARIE DO 72370 HSU, WILLIAM MD 72371 KOWENSKI, JACOB MD 72372 KARWOWSKI, ELIZABETH WOZNIAK MD 72373 MUBARAK ALI, FARAH MD 72374 KRAFT, MICHAEL CHRISTOPHER MD 72375 MOHAMMED, MUNEERUDDIN QUADIR MD 72376 JOSEPH, LINU CHANDY MD 72377 HAWK, ANGELA FISHER MD 72378 NATHAN, SACHEEN MD 72379 OKONGWU, FRANCELLE MD 72380 JAFARIAN, NAZANIN MD 72381 KAGUMBA, ADA ADHIAMBO MD 72382 OYEYINKA, MOYOSOYE MD 72383 MACE, JAMES EMORY JR MD 72384 NTUI-AYUK, GEORGE NTUI MD 72385 LAKE, LEENA MD 72386 MCKINNEY, DAVID LEON JR MD 72387 NEISEN, MELISSA JEANNE MD 72389 LAKE, ANDREW MD 72390 PATEL, AMRISH TARUNKUMAR MD


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72391 PATEL, BEJAL MD 72392 PATEL, CHINTAK MD 72393 MOOSA, YUNUS MD 72394 PATEL, DHAVAL D MD 72395 HANKINSON, SCOTT MD 72396 PATEL, DIPAN MD 72397 PATEL, KUNAL PRAVINCHANDRA MD 72398 PATEL, PRITESH MD 72399 PATEL, VAIDEHI MD 72400 ASHFORD, EMILY REBECCA MD 72401 PATEL, YOGESH N MD 72402 HOLMAN, BRITA JEAN MD 72403 JOSEPH, MICHAEL MD 72404 ALI, YUSUF M MD 72405 HORTON, MICHELLE BARBARA DO 72406 ATWATER, RONALD CLINTON JR MD 72407 PELLENBERG, ROD MD 72408 PENA, GABRIELA MD 72409 PETER, RENNY MD 72410 KHALID, MOHAMMAD ATIF MD 72411 ALEXANDER, ERIN T MD 72412 PETERSEN, EMILY ELIZABETH MD 72413 ABATE, MARGARET EDELWEISZ YVONNA ELAINE MD 72414 PETTIFORD, JANINE NICOLE MD 72415 PHILLIPS, WESLEY SCOTT MD 72416 ASSEFA, MESFIN T MD 72417 POLITE, ADRIENNE DO 72418 POTNICK, AARON MD 72419 PORTER, FERNANDO ANTONIO MD 72420 AMODEO, PHILLIP PAUL MD 72421 QUACKENBUSH, MICHAEL IAN DO 72422 ALMOND, MEGAN MD 72423 RAMIREZ, COLIN MD 72424 RANGE, DANIELLE MD 72425 REED, PAMELA SUE MD 72426 REZANIA, DORNA MD 72427 RICE, NICKLAUS TRENT MD 72428 RICHARDS, JINNE NIKI MD 72429 RIDINGS-HESSER, SANDRA LEA MD 72430 ROBINSON, LEDON ANTHONY MD 72431 ROHATGI, SAURABH MD 72432 SHAHEEN, TARIK MD 72433 SHAIKH, ILYAS A MD 72434 SHAKIR, TAAHA MD


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72436 SLOCUMB, CLAIRE LISE' MD 72437 BURKMAR, JENNIFER ANNE MD 72438 APPIAH-PIPPIM, JAMES AKWA MD 72439 SMITH, LAMONT CHARLES MD 72440 SOMANI, KARUN SHANKAR MD 72441 AHO, AMBER JOY DO 72442 SOOD, RAJIV DO 72443 AGUWA, UCHENNA DO 72444 ASENSIO-GONZALEZ, JUAN ANTONIO MD 72445 ROHDE, GERT DO 72446 ROSEBROCK, RICHARD MD 72447 ABDUL-KHALEK, RANA MD 72448 SORENSON, SCOTT MD 72449 RUTLEDGE, MICHAEL ROBERDS MD 72450 BUSKIRK, STEVEN J MD 72451 SPEAKS, ALLYSON WELLS MD 72452 SQUIRE, MICHAEL LOUIS MD 72453 STERN, GARY MD 72454 SAEED, ALIYA MD 72455 SWINK, JASON DUKE MD 72456 SZLAM, SARAH MD 72457 SAITO, ANGELA M MD 72458 SAJJA, RATNA MD 72459 UNGER, MICHAEL T MD 72460 BERNHARD, MATTHEW RENAUD MD 72461 UGBAJAH, WINSTON C MD 72462 VAUGHNS, CHRISTOPHER FRANKLIN II MD 72463 SAMS, JOHN CLARK MD 72464 VARKEY, SANTOSH C MD 72465 SAMUEL, SUHAS JOE MD 72466 SANDERS, JOHN PAUL MD 72467 VELAZQUEZ, JUAN G DO 72468 VICTORICA, CARLOS MIGUEL MD 72469 SANSGIRI, RAKHEE KISAN MD 72470 TAGG, WILLIAM MD 72471 VIRANI, ANISHA MD 72473 SARASWAT, AKHIL MD 72474 WABLE, SUMATHI MD 72476 WEBER, JILL MARIE DO 72477 WEEKS, DAVID MICHAEL MD 72478 SAADATMAND, BABAK MD 72479 WEISSHAAR, PAUL HOWARD MD 72480 WELCH, CRYSTAL LAVETTE MD 72481 CLERMONT, MICHELLE PATRICE MD


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72482 SAVAGE, BRISTOL YATES MD 72483 WELCH, JAMES W MD 72484 SAVITCHI, ELEONORA MD 72485 WERAGODA, RAMAL MAJINTHA MD 72486 SCHAFER, FERDINAND JOHANNES MD 72487 WETMORE, CYNTHIA MD 72488 TAHA, MAHDI MD 72489 SCHLEIFER, KIETH RANDOLF MD 72490 WHEELER, TYLER HENSON MD 72491 AYER, ROBERT EMERSON MD 72492 THABET, SALIM RIAD MD 72493 SCHREIBER, DONALD MERLE MD 72494 WHEELER, KIMBERLY DO 72495 SCHULENBORG, STEVEN PERRY MD 72496 ADEBAYO, JOLAADE MD 72497 WELTON, SCOTT T MD 72499 TEMPLETON, DAVID W MD 72500 SCHMITT, RICHARD ALAN MD 72501 WOLSKI, MICHAL J MD 72502 APPLEWHAITE, JANELLE MAUREEN MD 72503 WILLIAMS, LAURA GOWDER MD 72504 THOMAS, ANIL OOMMEN MD 72505 ARAIN, HUMA MD 72506 THOMAS, MATTHEW BRADY MD 72507 ANDERSON, STEPHEN MILLEDGE MD 72508 CORNEJO, SANTIAGO MARTIN MD 72509 TSUNG, ANN MD 72510 WHITE, TAMICA EVELYN MD 72511 WILLIAMS-THOMAS, KAMEISHA TENILE MD 72512 WONG, ALEXANDER WYMAN MD 72513 WYMAN, ANDREW JAMES MD 72514 YUN, SUNG RAK MD 72516 YEHNERT, HANS MD 72517 CHAN, DANIEL STEVEN MD 72518 BREUER, ANTHONY CARL MD 72519 YEOH, JIN SOON MD 72520 COLOVOS, NICK EDWARD MD 72521 ZIA, SUBAILA MD 72522 FOSTER, JAMES GRANBERY III MD 72523 BERGER, STEPHEN MD 72524 CHANDLER, ANNA RUTH MD 72525 CHISM, DAVID DEWAYNE MD 72526 CORBIN, DINA ZEKI MD


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72527 DOYLE, JOHN JOESPH MD 72529 FRANKLIN, ALLISON JANE DO 72530 DE JESUS, DANTE VELASQUEZ MD 72531 FALLIERAS, GEORGE NICHOLAS MD 72532 FLOYD, WALTER GRADY MD 72534 BARCHIE, MATTHEW FREDERICK MD 72535 FOSTER, TANJA JORDAN MD 72536 BERGAN, BRANDON RICHARD MD 72538 BROWN-JOHNSON, AMIRAH MD 72539 FERNANDEZ, ELVA ELIZABETH MD 72540 DESAI, NEIL KISHOR MD 72541 FASANO, REBECCA ELLEN MD 72542 BECHTEL, PETER MD 72543 DAVIS, GAVIN WADE MD 72544 DE FREITAS HERNANDEZ, JOHELIN FATIMA MD 72545 GEYER, DENNIS JAMES MD 72546 BERAUER, JOHN-PAUL MD 72547 FRAZIER, ALKETAH ROCHELL MD 72548 ALEMOZAFFAR, MEHRDAD MD 72549 GILLIS, DANNY JAMES MD 72550 BOOMSAAD, ZACKARY ELIAS MD 72551 DANGARIA, HARSH MD 72552 CHU, KAI-CHENG CARRIE MD 72553 GLUTH, AARON DAVID MD 72554 FELICIANO, CARLOS ERIC MD 72555 BARRERA, NOELLEMARIE ANTONIA DO 72556 GOWRAVARAM, SRIDEVI MD 72557 DOGAN-BAG, VAHIDE MERIH MD 72559 GARZA, JUAN JR MD 72560 BURGER, REBECCA KRISS MD 72561 CAMPBELL-BAYAAN, EVELYN MD 72562 DURAN, MARC ANTHONY MD 72563 GEISLER, JOHN PATRICK MD 72564 DAVIS, JONATHAN MD 72565 CHAMPION, HUNTER C SR MD 72566 CUBE, CESAR PADUA MD 72568 ELLIS, SHANNON MD 72569 CURRY, ALECIA ELAINE MD 72570 CAMERON, CRAIG DUNWODY DO 72571 BHATTI, SADAF FAISAL MD 72573 EWOH, CHARLES EGBO MD 72575 ELSAYED, TAMER M MD 72576 FEWLASS, DARIUS MD


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72578 GUYTON, FINDA LEE MD 72579 FOWBLE, COLEMAN DEANE MD 72580 FASANO, ROSS MARTIN MD 72581 BHATT, DARSHNA C DO 72582 LABORDE, DAVID VALENTINE MD 72583 MITTER, NANHI MD 72584 VELAYUDAM, KOHILAVANI MD 72585 ONUIGBO, NWAMAKA MITCHELLE MD 72586 SAFDAR, NABILE M MD 72587 PATEL, JAYMIN MANU MD 72588 SHARMA, VIBHASH DINESH MD 72589 GADLIN, SCOTTY LANE MD 72590 ROBERTS, RICHARD LOWELL MD 72591 TRIGG, STEVEN DEAN MD 72592 PAVASIA, NIRAV MD 72593 YAO, ANNIE MD

PAIN CLINIC ADVISORY COMMITTEE Dr. Weil presented the report of the Pain Clinic Advisory Committee as a motion. Dr. Butler seconded the motion, and it carried unanimously. Approved Applications:

1. DaVinci Medical Arts 2. My Pain Clinic 3. The Nexus Pain Center of Columbus 4. Southern Spine & Pain Institute – 3 locations 5. The Pain Specialist

Other Business:

1. Approved Clinics to change their Name: 1. Southeast Spine and Rehabilitation 2. Shefa Pain Consultants 2. Approved Request to transfer ownership - United Pain and Wellness of NE GA

Alvis Perry, MD to William Hill, MD 3. Approved Request to change Location: Physician Pain Care My FamilyDoc 4. Approved requests to add two APRNs and one Physician Assistant for Southeast Spine and

Rehabilitation: Monica McGowan, APRN, Brandi Gladden, APRN Diane Metzger-Commisso, Physician Assistant.


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5. Approved request to add one PA and APRN for The Hemlock Pain Center:

John Smith, Physician Assistant Torre Northcutt, APRN

6. Approved request to delete practicing physician: The Hemlock Pain Center ‐ James Boutselis

7. Approved request to add an APRN to the Athens and Gainesville locations: Spine Care and Pain Management – Andrea Mealor

8. Approved request to add two physician assistants: The Nexus Pain Center of Albany, Evans and Milledgeville, GA 1. Dustin Walsh – Albany location 2. Anthony Palazzo – Evans location

9. Approved request to add the following practicing physicians to the Nexus Pain Center: 1. Sandeep Datta – Evans 2. William Hammonds – Evans 3. Oluchi Ozumba - Evans 4. William Hammonds - Milledgeville

10. Approved request from Gainesville Pain Management to change the hours of the following practicing physician: Janet Griffin, DO

11. S.P.C. – Refer for consent order. 12. Approved request from Shefa Pain Consultants to add the following practitioners to the pain

clinics: 1. Mark Britton, MD 2. Jacob Ward, MD 3. Rebecca Hurd – APRN 4. Kim Naab – APRN

13. Table request from S.P.C. to add the following practitioners to the pain clinics. 1. C.T. MD 2. L.H., MD

14. Approved Committee recommendation to lapse all pain clinic applications that are not complete and over six months old. For pain clinic applications that are over six months old but have pending investigations, these applications are to remain as applications in process.

15. Advise Dr. Kroll that in order to have a pain clinic, he must have a physical location. PHYSICIAN ASSISTANT ADVISORY COMMITTEE Dr. Antalis presented the report of the Physician Assistant Advisory Committee with amendments as a motion. Dr. Powell seconded the motion, and it carried unanimously.

The Board took the following actions:

Approved Applicants pending Supervising Physicians: 1. LIS, TADECHER N 2. GODBOULDT, BEATRICE L 3. VADRIA, ANITA KHUSHBU


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Approved the following requests for additional duties: Physician Assistant License# Supervising Physician License# 1. BUSH, VENITA JOY 6087 PERRY, JOHN THEODORE 27421 Dialysis catheter placement and replacement 2. BRESSLER, SUZANNE S 3930 REDDY, PRAVEEN C 56471

CT-guided bone marrow biopsy and aspiration Lumbar puncture 3. DANIELS, CARA 7031 PENDEM, SHANTHAN 68271

Arterial line insertion Endotracheal tube intubation

4. FRIEDMAN, MATTHEW 7111 PENDEM, SHANTHAN 68271 Arterial line insertion

Endotracheal tube intubation Central venous line placement

5. GILLIS, JAMIE ANN 1923 DESAI, AASHISH KIRAN 52165 Arterial line placement Chandler pacing probe insertion Chest tube insertion Intubation Swan-Ganz Catheter placement Thoracentesis Triple Lumen Catheter insertion

6. HOLMES, KATLYN SUZANNE 6672 JOHNSTON, KIM WALDEN 24443 Lumbar drain / lumbar puncture 7. JOHNSON, DAVID ALAN 6863 KANG, BRANDON SANG JOON 54764 PICC line insertion 8. NORRIS, KENNETH L 2268 HARVEY, RICHARD LYNN 37827 Arterial line insertion

Central line insertion Pulmonary artery catheter placement Temporary pacemaker wire insertion and removal Radial artery harvest Chest tube insertion and removal Saphenous vein harvest Surgical chest closure

9. TRAN, QUYNH 7106 PENDEM, SHANTHAN 68271 Arterial line insertion Central line insertion

10. WOOD, ZACHARY THOMAS 7125 DEGRYSE, AMBER LEE 65537 Central venous catheter placement Tabled the following additional duties request for more information:

1. C.D. 2. C.D.L.


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Tabled the following application for additional information 1. M.D. 2. T.E. 3. B.G. 4. A.K.V.

Approved the following applications to add/change supervising physicians:

Physician Assistant Lic# Supervising Physician Lic# AHMADI, SHALYN BENAE 3389 SYROP, TAMA LYNN 43135 ARNETT, BRITTANY CARD 6422 FINDLEY, AMBROUS OLIVER JR 28267 AYERS, DANIEL T 2591 PISARELLO, JORGE 58914 BIGGS, BURKETT DONALD 506 PATEL, GAURAV PRAVIN 67305 BLEAKLEY, ELIZABETH 6700 DE LURGIO, DAVID BOWERS 40045 BOLING, CHARLES WAYNE 3551 GRANT, JESSE RAY JR 21510 BOOTH, BERTA ELENA 5897 BARLOW, JAMES B 30717 BOSTIC, KENNETH 3528 HOLTZCLAW, JAMES FREDERICK 35906 BOSWELL, DENNIS HOYT 2742 HAYNES, GAYE NICOLE 49696 BOSWELL, DENNIS HOYT 2742 LOVVORN, JUSTIN DALE 62249 BOUTSELIS, JAMES ANGELO 1535 KEOMAHATHAI, SACKDINANH N 51054 BOWDEN, TODD ARRINGTON 5127 HALLOWES, WILLIAM 35893 BRAND, KEMPER MARION 6237 KOHLI, HIRA 60290 BROCK, GINA MARIE 7168 WAZEERUD-DIN, SULIEMAN A 60891 BROCK, HEATHER SUZANNE 3270 FERRELL, THOMAS JR 8433 BROWN, LINDSEY AUSTIN 6239 DONNELLY, CASSANDRA B 68144 BURDETSKY, MARGARITA G 3622 VANN, JODI WOLFE 41988 BURKE, GREGORY LANIER 2771 KETCHEY, CHRISTOPHER C 63875 BURKE, TRACY FOSSAS 6353 HORNSBY, JAMES LARRY JR 54389 CASANOVA, PEDRO 2333 BURRESS, THOMAS 67539 CAVINESS, STEPHANIE GREATHOUSE

6430 WOODHALL, DANA 66843

CHAPPUIS, RICK ALAN 3558 MARTINO, JOSEPH ANTHONY JR 37023 CHOKSY, VAIRAGI 7145 AUSTIN, JACK HULON JR 32689 CLARK, AMANDA 6480 DALTON, BOOKER HUGHES 35608 COOPER, MARY LANE 1586 GARDNER, ALETA M 46851 CROSBY, STEPHEN B 5461 SHERWOOD, BOZEMAN K 26379 CROUCH, ROBERT JOSEPH III 6426 ANTHONY, CLEMENT REESE 27752 DAVENPORT, LISA ZAMMIT 3468 RIVES, PETER ANDREY 61646 DEAN, ALAN B 1540 KEEFE, BRIAN THOMAS 37587 DEBRAGGA, STEPHANIE KURTZ 6729 BERNAL, LEON 57283 DEV, JASMINDER SINGH 5853 OPARE, NANA KWAKU 58113 DLUGOS, DINA ELLEN 3394 MA, GRACE YU-CHUN 47345 DOVIE, ERIKA 4281 GOTTSCHALK, JENNIFER C 62991 DUANE, PRESCOTT BOWERS 2892 CLARK, KUDIRATU A 69565 EARNHART, MARIA M 5628 LEE, EDWARD 43681


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Physician Assistant Lic# Supervising Physician Lic# EASON, JESSE BLAIR 6090 DAVENPORT, JEFFREY PATON 63574 ESHLEMAN, BRANDON LEE 6606 ELLIOTT, LA-SHAUN DENISE 68404 FELDER, MARTHA 6978 KING, ROBERT EDWARD 53835 FINLEY, HEATHER LOUISE 2462 MAGUIRE, RICHARD ROBERT 58278 FISHER, GREGORY LEE 2916 PARROTT, MAXWELL 45574 FISHER, GREGORY LEE 2916 TAPLEY, CHARLES LEON 53712 FLETCHER, ANNA H 6909 SCHINELLI, ANTHONY 37362 FORT, KEITH WESLEY 6400 SUTPHEN, SUSSAN KAYE 37396 GARRISON, LINDSEY ANN 6657 TALLEY, ROY LAMAR JR 29957 GBADAMOSI, AHMED O 6071 RICHARDSON, EDDIE JR 52047 GIDDENS, SHANE LEON 5490 POWERS, JOSEPH MATTHEW 69933 GONZALEZ, ANNIE MARIE 7189 OSHINOWO, ABAYOMI G 43447 GORRA, VALERIE 7050 CURRIER, STEVEN JAMES 65231 GREEN, MARK STEPHEN 2321 DAVENPORT, JEFFREY PATON 63574 GRILLO, BRUNO JOHN 4809 SHEIKH, ABDUL MALIK 52017 GUNDER, SHAWN E 2919 PARFENCHUCK, THOMAS ALAN 39651 GUTIERREZ-CARDI, RACHEL ANN 6489 BELLAMY, MICHAEL ALLEN 70530 HAYNES, JONATHAN 7073 FYE, CHIQUITA AGATHA 20707 HEDRICK, JAMES ELBERT 3729 ESPETIA, OSCAR DAVID 65358 HENNEK, KRISTIN KYLE 7170 GRANGER, JAMES ROCHESTER III 55824 HERRING, TONI LYNN 6360 JAMES, RICHARD PEELE JR 49455 HOLLAND, JANET L. 3013 MCBRAYER, DANIEL ENOCH 18697 HOWARD, THOMAS AUSTIN 4631 ANGEL, JOSE FERNANDO 17360 HUTCHESON, TROY EUGENE 4831 TAYLOR, EARLE MCRAE 25298 HUYGHUE, YOLANDA MARIE 4011 BURKE, RACHEL DAMARIS 66997 ITACY, RAYLLENSONS 6147 GRUPKA, MICHAEL JORDAN 60588 JACKSON, REBECCA DOTT 5467 EISENBERG, STEVEN JAY 36146 JACKSON, REBECCA DOTT 5467 NGUYEN, ELIZABETH THUY N 55682 JACQUET, NELSON 4350 CHENG, ALAN CHUNG-KEE 66271 JEAN-JACQUES, EMMANUEL 5535 BARRETT, CAROL ANNE 70044 JEAN-JACQUES, EMMANUEL 5535 OLIGA, JEANINE BARKER 49363 JEFFERSON, ANDREVIUS T 4496 MCLENDON, KENNON ALLEN 33393 JENNINGS, DONNA FAYE 6577 SCHUH, MARTHA BLACKWELL 37488 KNORR, PATRICK RYAN 6434 REHMAN, OBAID 44990 KRUPANSKY, CRAIG 7093 RICE, KENNETH MACLEOD 47251 LANDERS, PAMELA BRITT 1795 DAUPHIN, BRIDGET ANTOINETTE 55199 LEWIS, CHAD EDWARD 5094 PATEL, JITESH VINOD 65869 LIBBY, ALICIA 6182 SPURLOCK, RICK JR 59207 LINDSAY, KIMBERLY KATHRYN 6388 MONTANA, SUZANA MARA 45097 LOGAN, SHARON COFFIELD 4536 PATEL, TARAK VIPINCHANDRA 66394 MATUZA, CHARLES 1433 GOTTSCHALK, JENNIFER C 62991 MCCARTHY, DANIEL JOSEPH 5280 REDD, DOUGLAS CHARLES 32463 MILLER, KELLY H 6862 DALVI, ANANT G 63849


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Physician Assistant Lic# Supervising Physician Lic# MOORE, CHASKA LASHAWN 4012 CHOI, JONG JIN 52043 MORRIS, KIAN 7079 REAMES, DAVIS 72096 MOUGHAMIAN, DENICE LOUISE 2616 BERGERON, RHET LEON 44683 MUELLER, MEGAN DOWDY 6014 CASTRESANA, MANUEL RAMON 22729 NORTON, SARAH ELLEN 6101 WU, CHANGCHUN 61537 ORCIUCH, NIKKI 6321 DOUCHY, CHARLES JACOB 66516 ORTEGA, OMAR 6996 KANYE, WILLIS 64699 PAN, YA-PING 1973 ERCEG, STEFAN KENNETH 64371 RADCLIFF, SANDRA LOUISE 6793 ESTARIS, JOVITO BUADA 22544 REILLY, EDWARD 4794 SMITH, GARY 10666 RHOADES, ADAM N 7080 KABBANI, AZMI 31171 ROBERTS, HANNAH 5051 HOUSE, JOHN CLIFFORD 11959 ROBINSON, TERRY LYNN 3629 OSHIYOYE, ADEKULE E 70219 ROCI, MORGAN 7104 ELLENOFF, BONNIE POLLOCK 51644 SARTORI, JAMES H 2380 JHEE, THOMAS SEUNGNAM 20447 SATCHELL, TIFFANY MELISSA 5145 JAMES, TIENCIA DOROTHEA 58882 SAWYER, JEWEL 6190 POAG, JOYCE HOUSTON 21355 SCOGGINS, BRETT RAYE 2841 ERCEG, STEFAN KENNETH 64371 SEN, CRYSTAL CLARK 5269 PEPPER, KARA JEHLE 59847 SHAH, NITI 7004 MADU, APRIL 66175 SHEARER, GWENDOLYN 6895 KARIM, YASMIN KHADIJA 66194 SHEPS, MARYANN CHRISTINE 7169 BAKER-BROWN, JUDIETH E 36090 SIMMS, JOHN EDWIN 1266 ROBERTS, MARCUS CARROLL 35986 SMITH, AMANDA HEATHER 5444 ERCEG, STEFAN KENNETH 64371 SPENCER, JASON C 3768 THOMPSON, ALBERT MARION JR 22338 SULLIVAN, SAMANTHA 7141 SHKLYAR, BORIS 65180 SUMMER, BEN 7162 DUCHYNSKI, MICHAEL PATRICK 71336 SUPRUNIUK, IRINA 3613 OUDERKIRK, JOHN PHILLIP 49992 SYED, SEEMIE NAZ 5510 SWAMI, RAJENDRA VIPIN 30226 TAYLOR, ANTHONY KEITH 4325 BARNARD, HENRY HARRIS II 37961 TAYLOR, KRISTIN S 6019 MEIER, EDWARD 43426 THOMAS, REBEKAH EVELYN 6585 TATA, UDAY KUMAR 53413 TILTON, LORI YOUNG 4326 D'ANNA, FRANK JOSEPH 36952 TOMAN, AMBER LEIGH 5452 LAM, JASON CHUN SANG 60528 VAUGHNS, RABIA LYNNE 5609 BLAKE, BRYAN DAVID 40613 VON DER SCHULENBURG, AMANDA

3997 MA, GRACE YU-CHUN 47345

VON DER SCHULENBURG, AMANDA

3997 WANG, THERESA 70000

WEEKS, MORGANNE MELISSA 6807 RIVES, PETER ANDREY 61646 WEINISCH, ERIN KIM 6109 HARTMAN, MICHAEL GLENN 33350 WILSON, CHARICE JORDAN 6661 ODETOYINBO, ADEDAPO O 55829 WOLFF, WILLIAM H 1042 MERCHEN, TODD 58986


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Physician Assistant Lic# Supervising Physician Lic# ZUNDEL, SHANNON DAWN 5735 FONG, PETER EDWARD 56467 Approved the following initial applications for licensure: Physician Assistant File# Supervising Physician License# ABNEY, DAVID H 6226 BARLOW, JAMES B 30717 ANDERSON, NATE EDWARD 6260 ILLSTON, BLAKE JEFFREY 68035 BAER, CHELSEA MARTHAN 6254 ROSS, CHARLES BRIEN 68549 BALDWIN, PATRICIA F 6217 ROGERS, JOHN JAMES 21040 BLANKS, BENJAMIN P 6259 LEE, GREGORY PRICE 48121 BROWN, MELISSA RENEE 62257 TRINH, HAI HONG 55991 CARLSON, CATHERINE ANN 6255 THANKACHAN JACOB, ARUN 69981 CHAUSSINAND, DANIELLE M 6270 KAVALI, CARMEN MICHELLE 50968 CHEN, YUEGANG 6195 HOOTS, ANTHONY VON 33114 COLEBURN, NATASHA C 6161 MADUKA, YVONNE M 64804 DALY, MEGAN 6250 OLIVER, DAVID STEVEN 38323 DIPRIMA, KIMBERLY 6233 WILKES, JOSEPH SHEPPARD 21442 ELLIS, JASMINA LEIGH 6228 MURRAY, STUART WILSON 31080 FOUNTAIN, KATIE 6223 KEEFE, BRIAN THOMAS 37587 GARCIA, SHAWN DWAYNE 6137 SYMBAS, NIKOLAS PETER 42127 HENLEY, SAMANTHA 6241 CANNON, CLIFTON L III 59051 HEWIT, LEANNE PATRICIA 6256 CARR, FELICIA GLORIA 28190 HOOKS, DELAINA MARIE 6272 KHANSARINIA, SAEID 50649 HOWARD, MANDI 6187 BOYCE, BRANDON MARK 67392 JONES, STACIA WOOD 6194 BISHOP, RANDOLPH COURTNEY 41516 KRIEGER, CAITLIN E 6234 RICHARDSON, EDDIE JR 52047 LEE, JULIA SANG-MI 6224 SPITZLER, SUSAN RUDNICKI 45342 MCELVEEN, VICTORIA C 6243 BRUCE, BRANDON 71050 MELTON, JEREMY DANIEL 6221 TERRELL, WILLIAM DEAN 41688 MOHAN, LAURA 6227 KINAHAN, JAMES JOSEPH 32577 MORELAND, WHITNEY 6229 HENRY, HEATHER A 44231 MUSILLE, ROSE M 6248 RAJAGOPAL, VIVEK 59318 OLISE, PATRICK O 6237 DALVI, ANANT G 63849 PATEL, NIRALI D 6232 MURRAY, STUART WILSON 31080 PHILIP, STACEY 6244 PRIDE, YURI BERNARD 69617 PIETRANGELO, LISA 6249 STEPHENS, CHARLES RAY 58785 RIVAS, RODOLFO ORESTES 6193 VELASQUEZ, JONATHAN 48581 SMITH, ERIKA HARVEY 6225 PARRISH, WILLIAM ELIJAH 47989 SMITH-WILLIAMS, JENNIFER 6265 CADIER, THOMAS ROCHE 16320 STANLEY, JULIA ANNE 6252 GREY- MCBRIDE, MONIQUE 71236 VIAR, BRITTNEY 6258 KIM, ELI YONG 70656 WADE, CHRISTOPHER 6213 BURRESS, THOMAS 67539 WASSON, JESSICA LEIGH 6158 NICOME, NICOLE K 60133 WHATLEY, PETER BIRAM 6242 JEFFORDS, KELLAND K JR 49041


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Physician Assistant File# Supervising Physician License# WILSON, DORICE REENA 5490 HATMAKER, DAVID LARRY 26300 WILSON, VIRGINIA 6240 ROSS, MARY KAY 55437 WOOLSEY, CHERYL ANNE 6132 DICKHAUS, DELLICE MARIE 61842 WITSIEPE, KARA NISBET 6239 DAVIS-MITCHELL, WENDY 45442 WRIGHT, RENEE THERESE 6251 MA, GRACE YU-CHUN 47345 Other Business:

1. The Board clarified that when physician assistants request the Board’s approval for additional duties that the Board has approved them to perform under other supervising physicians, the PA is not required to provide case logs to demonstrate competency.

2. E. C. - Rescinded licensee’s ANTP with Board; Required 240 hours of supervised practice; Required 4 quarterly reports from supervising physician; Required CME logs for the time the licensee was out of practice.

3. E. L. - Accepted update from PHP 4. Morris, Timothy Alan (1386) - Accepted documentation of licensee’s completion of Board-

ordered supervised practice; Lifted consent order requiring supervised practice 5. C. W. - Accepted update from PHP

RESPIRATORY CARE ADVISORY COMMITTEE Ms. McGarity presented the report of the Respiratory Care Advisory Committee as a motion. Dr. White seconded the motion, and it carried unanimously. The Board took the following actions:

Approved Applicants requesting 12-month permits: Florida A&M University 1. Johnson, Tamickqa Georgia State University 1. Lee, Travis Lake Superior College 1. Cogswell, Desirae Middle Georgia State College 1. Claggion, Morgan 2. Everson, Jennifer 3. Fogarty, Carlton 4. Sheffield, Gloria Southern University 1. Howard, Erika South West Community College 1. Moody, Amanda


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Approved Applicants by Reciprocity: 1. Badou, Luzette – pending additional information 2. Brown, Delori

3. Dennis, Kim – pending additional information 4. Dobbins, Lori 5. Gamez, Lina 6. George, Lali 7. Joseph, George 8. Ousley, Herman – pending additional information 9. Park, Chimene 10. Vincent, Jaysen

Approved Applicants for Reinstatement: 1. Ekler, – pending additional information 2. Garnett, George – pending additional information 3. Linch, Lessie 4. Ray, Marilyn – pending additional information 5. Smith, Christie – pending additional information 6. Staystork, Charlene

Approved Applicants for Permanent licensure 1. Nezat, Shelli 2. Romiluyi, Omotayo

Approved Applicants for Licensure:

1. Bellfleur, Annie 2. Fambro, Michelle 3. Hurkes, Shanice 4. Lott, Marcus Jr. 5. Louis-Charles, Viola 6. Pierre, Anslem 7. Sisco, Evelyn 8. Tesfu, Mahlet

ADVANCED PRACTICE NURSE ADVISORY COMMITTEE Dr. House presented the report of the amended APRN Advisory Committee as a motion. Dr. Deloach seconded the motion, and it carried unanimously. The Board took the following actions: The following protocol agreements meet the provisions of OCGA 43-34-25: APRN DELEGATING PHYSICIAN

Abramson, Cara Dubovsky, Daniel MD Akins, Kathy Brantley, David MD Asa, Michelle Hopkins, Alicia DO Atkins, Bethany Turfler, David MD


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Banister, Anna Laygo, Romualdo MD Banner, Laura Blevins, Shaena MD Barco, Angela Sherwood, Bozeman MD Barlow, Paula Gwathney, Miriam DO Bentley, Melissa Vermeer, Todd MD Black, Tekesa Montaque Jr., Freeman. MD Botero, John Adisa, Wasiu DO Brown, Darlene Price, James MD Brueshaber, John Nikolinakos, Petros MD Byers, Ann Blevins, Shaena MD Caldwell, Cindy Smith, Kevin MD Callahan, Kimberly Spencer, Dennis DO Chabot, Judith Outz, Charles MD Clark, Tiffany Martin, Garland MD Coleman, Kelly Marler, Robert MD Comer, Judith Dawis, Jeffrey MD Cooper, Layla Wyatt, David MD Crandall, Lisa Parikh, Naresh MD Creed, Tracy Sumandeep, Sangha MD Curtis, Tommy Moss, Kelvin MD Dada, Oasumbo Subich, Davis MD Davis, Michelle Hoots, Anthony MD Dees, Latasha Rubin, Mitzi MD Denly, Gregory Espetia, Oscar MD Faudree, Cyndi Bailey Jr., Marion MD Floyd, Linda Rasalam, Livingston MD Folds, Hannah Francis, Woody MD Fowler, David Risby, Emile MD Frederick, Carlie Risby, Emile MD Freeman, Christi Weiss, Lawrence MD Gipson, Tonya Garland, Brenda MD Gokal, Payal Ghamande, Sharad MD Gooding, Karen Sumandeep, Sangha MD Goodman, Erin Hundley, Jonathan MD Gregory, Shalia Hales, Chadwick MD Gregory, Shalia Hassar, Ihab MD Gregory, Shalia Hu, William MD Gregory, Shalia Lah, James MD Gregory, Shalia Levey, Allan MD Gregory, Shalia Krishnankutty, Sathian MD Hails, Catherine Cooper, William MD Hall, Koreen Onwuanyi, Ankwe MD Halvey, Kathleen Hott, Brenda MD Harrison, Shirley Owens, Crystal MD


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Hodnicki, Deanna Deal, Michael MD Hooker, Tanisha Sumandeep, Sangha MD Hudson, Virginia Cunnigham, William MD Hudson-Gallogly, Wanda Danforth, Christine MD Hughes, Tammy Tehrani, Nasser MD Hunter, Tamara Hunt, Loren MD Hurst, Sabine Clearly, Kevin MD Jewell, Lisa Steele, Collyn MD Johnson, Courtney McLendon, Kennon MD Johnson, Mae Voegele, Stanford MD Jordan, Sarah Kasongo, Mana MD Kaimachiande, Finda-Mani Rogers, Tosha DO Kappes, Julia Campbell, Robert MD Kent, Yolanda Agarwal, Deepali MD Kiewit, Deura Oreus, Maxcene MD Kilgore, Catherine Baron, Michael DO Knudsen, Irina Shin, Dong Md Langston, Lydia Sogade, Bola MD Leary, Bridget Sogade, Felix MD Lee, Cindy Coleman, William MD Leigh, Stacy Goo, David MD Lemberg, Robert Dalvi, Anant MD Ley, Kristen Kumpel, Tiffany MD Mallory, Edna Roman, Charles DO Mansfield, Elizabeth Bennett, Garrett MD Mathis, Stephanie Thomas, Susan MD McLeod, Melissa Sinclair, James MD McNeal, Virginia Ajayi, Edward MD McNulty, Amanda Wilson, Robert MD Mealor, Andrea Holladay, Janene MD Medlin, Helen Day, Zenobia MD Merritt, Marcie Mann, Thomas DO Meyer, Rebecca Blevins, Shaena MD Millsap, Lori Battle, Lee MD Momoh, Isata Hogan, Matthew MD Morris, Katherine Batlle, Maria MD Nelson, Christy Hill, Van MD Nothcutt, Torre Tafor, Stephen MD O’Flynn, Tamsyn Faulk, David MD O’Hara, Janet Kornblatt, Brian MD Obuba, Joseph Burton, Kelvin MD Okoro, Ngozi Mayfield, Jan MD Painter, Susan Aleem, Asaf MD Parker, Sandra Rossi, Peter MD


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Penland, Erin Libert, Cynthia MD Perkins, Gloria Thomas, Susan MD Peters, Chanya Nesmith, Charles MD Phillips, Amanda Oddis, Carmine MD Phillips, Karen Van, David MD Pickett, Angelique Ward, Bradley MD Pinyerd, Abby Singh, Amar MD Pryor, Julie Cooper, Carroll MD Pryor, Julie Cooper, Carroll MD Pryor, Julie Gavrikov, Vitaliy MD Pryor, Julie Gavrikov, Vitaliy MD Ralph, Amanda Runyan, Thomas MD Rangnow, Katie Faith, Daniel MD Reardon, Thomas Ash-Mapp, Nicole MD Rease, Lashandra David, Dion MD Rentz, Anna Herrbold, Francis MD Richardson, Cynthia McLendon Jr., Julian MD Rinehart, Cynthia Pirani, Safia MD Rivers, Tammy Harvee, Gulsha MD Rogers, Candice Dasher, Glen MD Round, Sally Fazal, Javed MD Sahatevasukont, Chitchawal Aleem, Asaf MD Sandord, Sally Rojas, Eduardo MD Sanford, Sally Evans, Donald MD Savage, Kimberly Brown, Christopher MD Shah, Payal Patel, Dhameshkumar MD Smith, Janet Mayfield, Jan MD Smith, Melissa Queen, Susan MD Smith, Melissa Risby, Emile MD Sparks, Tony Hatmaker, David MD Standiford, Christen Zottoli, Lawrence MD Stargell, Elizabeth White, James MD Stewart, Martha Weinberg, Paul MD Stout, Mandy Moy, Alan DO Thackston, Tricia Ash-Mapp, Nicole MD Thompson, Jennifer McLendon Jr, Julian MD Trent, Amy Udo, Emem MD Tripp, Sarah Thakore, Hetal MD Uba, Helen Morgan, Marla MD Uba, Sabo Dawson, Angela MD Wagner, Jaclyn Faith, Daniel MD Walker, Jenny Dyer, Divina MD Weinberger, Ellen Smith, Walter DO White, Dianna Clark, Teresa MD


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White, Rhonda Stevens, Christopher MD Willard, Karen Houry, Debra MD Williamson, Ronda Whitlock, Paul MD Wooley, Kari Delgado, Redan MD Works, Lesley Flowers, David MD Yarnell, Richard Middlebrooks, Edward MD Yelton, Pepita Greaves, Paula MD

The following protocol agreements meet the provisions of OCGA 43-34-25 with additions or changes: APRN DELEGATING PHYSICIAN

Becker, Deborah Sial, Rubina MD Bellamy, Dene Mendoza, Delquis MD Briggs, Natalie Barlow, Jim MD Cheeseman, Karen Aleem, Asaf MD Cochran, Angela Kelly, Scott MD Crouse, Sharon Davis, Thomas MD Desandre, Carolynn Danforth, Christine MD Dobbs, Monica Baldwin, Richard MD Dressler, Susan Thompson, Teresa MD Hart, Kimberly Baldwin, Richard MD Hummel, Mary Danforth, Christine MD Keller-Vice, Hayley Hong, Gayoung, MD Lewis, Ellen Katragadda, Suneel MD Mullis, Laura Taylor, William MD Randall, Rhonda Captain, Anthony MD Reynolds, Sharon Varnell, James MD Story, Heather Franco, Fabian MD Townsell, Barbara Strickland, Catherine MD Townsell, Barbara Budlong, Brenda MD Trachhia, Maureen Blank, Stephen MD West, Carolyn Martin, Nicolle MD

Other Business:

1. Approved additional procedures for agreement between Dana Petersen & Dr. Jeffrey Peretz. 2. Denied additional procedures for agreement V.R. and S.D., MD. APRN has not completed

training as required by the Board. 3. Board confirmed that as per OCGA 43-34-25, the delegating or other designated physicians

are required to review and sign a total of 10% of all of the NPs patient records for whom he/she has delegated prescriptive authority.

4. The Board has no information regarding possible legislation to take effect in 2015 requiring acute care certification vs. family certification in a hospital setting. Committee will revisit the subject at the August 2014 meeting.


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5. Protocol agreement between C.R. and R.B., MD – physician no longer meets the criteria for a delegating physician. NP has not submitted a new agreement with a new delegating physician as required by the Board (June 2014) and is illegally practicing under OCGA 43-34-25. File will be forwarded to Enforcement.

PERFUSION ADVISORY COMMITTEE Dr. White presented the report of the Perfusion Advisory Committee as a motion. Mr. Powell seconded the motion, and it carried unanimously. The Board took the following actions: The Board took the following actions. Approved Applicants for Licensure: Sterina Hill

Dale Ruby Alois Lesch Emily Sauliti

Other Business: Reviewed Committee request for clarification on how they would handle a response from an applicant for initial licensure or renewal that they may not be able to practice with reasonable skill and safety. Board advised they would review these responses on a case by case basis.

CLOSED MEETING Dr. Deloach made a motion, seconded by Dr. Gross, to go into closed session to discuss pending litigation, investigative, and Wellness Committee matters. The motion carried unanimously. OPEN MEETING Dr. Retterbush declared the meeting in Open Session. WELLNESS COMMITTEE Dr. Powell presented the report of the Wellness Committee as a motion. Mr. Wallace seconded the motion, and it carried unanimously. The Board took the following actions:

PHP report received. 1. Julian Gordon, MD- Approve order terminating probation. 2. Robert J. Straub, MD- Approve order terminating probation. (Dr. Grossman recused) 3. Hugh Hall, MD- Table. 4. Case #20091621-Grant request to terminate monitoring. 5. James DeSantis, MD- Deny request. 6. Ronald Trotman, MD- Deny request. 7. Case #20090826. Grant request to terminate monitoring. 8. Jerry G. Purvis, Jr., MD- Table. (Dr. Retterbush, Dr. Deloach, and Dr. Powell recused). 9. Daryl Ellis, MD- Approve order terminating probation. 10. Anthony Securo, MD- Deny request.


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Other Business Discussion of Board lists of facilities approved to conduct evaluations. INVESTIGATIVE COMMITTEE Dr. Deloach presented the report of the Investigative Committee as a motion. Dr. Deloach. seconded the Committee’s motion, and it carried unanimously. The Board took the following actions: Recusals: McGarity: 20141176 Mohan: 20131211 20131212 20131213 DeLoach: 20141201 Retterbush: 20140623 20141179 20141191 Powell: 20140623 Butler: 20141199 House: 20141199 Slappey: 20141199

Close: 20130181 20131212 20131213 20131214 20140696 20140967 20141047 20141049 20141102 20141286 20141373 20141382 20130385 20130764 20131153 20140620 20140700 20140718 20140746 20140747 20140752 20140763 20140769 20140771 20140804 20140815 20140828 20140836 20140837 20140868 20140928 20140929 20140931 20140954 20140965 20140988 20141000 20141004 20141006 20141009 20141011 20141015 20141022 20141025 20141048 20141055 20141064 20141066 20141069 20141071 20141075 20141080 20141082 20141088 20141089 20141098 20141131 20141142 20141145 20141151 20141154 20141174 20141178 20141195 20141200 20141204 20141211 20141216 20141239 20141242 20141243 20141263 20141266 20141270 20141273 20141323 20141339 20141343 20141375 20141380 20141450 20141457 20140998 20141061 20141166

Close with Letter of Concern: 20121502 20130691 20130765 20131753 20140520 20140643 20140995 20141017 20141067 20141084 20141179 20141191 20141260 20141421 20141431 20141551 20141181

Invite for Interview: 20131211 20131533 20140566 20140584 20140885 20141176 20141199


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Table: 20140945 20141201 20141598 20121568 20140529

Further Investigation 20140623 20140843 20141569

INITIAL COMPLAINT EVALUATIONS Close: 20141109 20141289 20121330 20141338 20141340 20141345 20141346 20141348 20141355 20141358 20141360 20141384 20141396 20141397 20141408 20141420 20141437 20141441 20141448 20141455 20141461 20141463 20141464 20141478 20141486 20141487 20141509 20141530 20141540 20141544 20141548 20141549 20141550 20141557 20141566 20141591 20141751 20141503

INVESTIGATIVE INTERVIEW REPORT

1. 20131666 Reschedule 2. 20141501 TABLE 3. 20140818 NO SHOW 4. 20140580 CLOSE 5. 20140528 CLOSE 6. 20131509 CLOSE w/LOC 7. 20131261 TABLE 8. 20131653 & 20140262 CLOSE & Terminate Order

Other business: 9. 20140581 CLOSE

ADJOURNMENT Dr. House made a motion, seconded by Dr. Powell, to adjourn the July 10, 2013 Board meeting. The motion carried unanimously. Dr. Retterbush adjourned the meeting. ____________________________ ________________________________ David Retterbush, MD LaSharn Hughes, MBA Chairperson Executive Director Recorded by Diane Atkinson

Documents

GEORGIA COMPOSITE MEDICAL BOARD MINUTES JULY 10, 2014 · GEORGIA COMPOSITE MEDICAL BOARD MINUTES JULY 10, 2014 3 15. Dana Thomas emailed wanting to clarify that a medical assistant