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Posted: 3/2/2020 2:54 PM MD Agenda
Susan Chambers, MD, Board President ~ James Brinkworth, MD, Board Vice-President Mr. Clayton Bullard ~ Louis Cox, MD ~ Mark Fixley, MD ~ Mr. Jeremy Hall ~ Mr. Robert Howard ~ Mr. Trevor Nutt
David Vanhooser, MD ~ Ann Warn, MD ~ Don Wilber, MD
1
Agenda Board of Medical Licensure and Supervision
Regular Meeting March 5, 2020
This meeting of the Board will be held at the office of the Board, 101 NE 51st Street, Oklahoma City, Oklahoma in accordance with the Administrative Procedures Act and Open Meeting Act of Oklahoma.
The Board may discuss, vote to approve, vote to disapprove, vote to table, change the sequence of any agenda item, or vote to strike or not discuss any agenda item.
*INDIVIDUAL PROCEEDINGS: Review and action on all agenda items noted for individual proceedings. In all agenda items noted for individual proceedings, a majority of a quorum of Board members, in a recorded vote, may call for closed deliberations for the purpose of engaging in formal deliberations leading to an intermediate or final decision in an individual proceeding under the legal authority of Oklahoma state statutes, to wit: Article II of the Oklahoma Administrative Procedures Act, 75 O.S. §309 and the Oklahoma Open Meeting Act, 25 O.S. §307(B)(8).
9:00 A.M.
___ Meeting called to order
___ Opening remarks – Lyle Kelsey, Executive Director
___ Board Advisor Comments – Robert C. Margo, JD
___ Review, discussion and possible action – Minutes of the January 16, 2020 Meeting
___ Review, discussion and possible action – Proposed permanent rule revisions to Okla. Admin. Code 435:35-1 (Licensed Dietitians)
___ Review, discussion and possible action – Proposed permanent rule revisions to Okla. Admin. Code 435:30-1-2, 1-4, 1-5, 1-15, and 1-18 (Occupational Therapists and Occupational Therapy Assistants)
___ Review, discussion and possible action – Proposed permanent rule revisions to Okla. Admin. Code 435:20-9 (Physical Therapists and Physical Therapist Assistants)
___ Review, discussion and possible action – Second request of STEPHEN FEUERBORN, MD, to supervise additional mid-level practitioners
___ Review, discussion and possible action – Request of IAN S. THOMPSON, MD, to supervise additional mid-level practitioners
Posted: 3/2/2020 2:54 PM MD Agenda
Susan Chambers, MD, Board President ~ James Brinkworth, MD, Board Vice-President Mr. Clayton Bullard ~ Louis Cox, MD ~ Mark Fixley, MD ~ Mr. Jeremy Hall ~ Mr. Robert Howard ~ Mr. Trevor Nutt
David Vanhooser, MD ~ Ann Warn, MD ~ Don Wilber, MD
2
I. INITIAL APPLICATIONS FOR LICENSURE
___ JOHN TYLER, applicant, full medical licensure
___ NANETTE JAMES-PATRICK, applicant, full medical licensure
II. INDIVIDUAL PROCEEDINGS
A. APPLICATION FOR LICENSURE
___ *CHAI S. CHOI, MD – applicant, reinstatement of full medical licensure
B. PROBATIONARY MATTERS
___ *SUANNE MELANIE DAVES, MD – (Staff) Motion to Terminate Agreement
C. DISCIPLINARY MATTERS
___ *DOUGLAS RANDALL BROWN, MD – Defendant's Motion to Compel
___ *WILLIAM DALE WRIGHT, MD – Motion to Enforce Board Order
___ *ABOLGHASEM REZAEI, MD – Disciplinary hearing based on allegations of failing to comply the term(s) of an Agreement; conduct likely to deceive, defraud, or harm the public; and violation of any provision(s) of the medical practice act or the rules and regulations of the Board or of an action, stipulation, or agreement of the Board.
___ *MARK REIHELD, MD – Disciplinary hearing based on allegations of prescribing, dispensing or administering of controlled substances or narcotic drugs in excess of the amount considered good medical practice, or prescribing dispensing or administering controlled substances or narcotic drugs without medical need in accordance with published standards.
___ *SCOTT PARKHURST TURNER, MD – Disciplinary hearing based on allegations of fraud or misrepresentation in applying for or procuring a medical license or in connection with applying for or procuring periodic re-registration of a medical license; and using a false, fraudulent, or deceptive statement in any document connected with the practice of medicine and surgery.
___ *MARK STEPHEN WILSON, MD – Motion to Continue; and possible disciplinary hearing based on allegations of habitual intemperance or the habitual use of habit-forming drugs; and the inability to practice medicine with reasonable skill and safety to patients by reason of drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material.
Posted: 3/2/2020 2:54 PM MD Agenda
Susan Chambers, MD, Board President ~ James Brinkworth, MD, Board Vice-President Mr. Clayton Bullard ~ Louis Cox, MD ~ Mark Fixley, MD ~ Mr. Jeremy Hall ~ Mr. Robert Howard ~ Mr. Trevor Nutt
David Vanhooser, MD ~ Ann Warn, MD ~ Don Wilber, MD
3
___ *MARK DOUGLAS FOSSEY, MD – Disciplinary hearing based on allegations of failure to establish a physician/patient relationship prior to providing patient-specific medical services, care or treatment; and failure to maintain adequate medical records to support diagnosis, treatment or prescribed medications.
___ *WILLIAM C. BRADFORD, MD – Disciplinary hearing based on allegations of failure to keep complete and accurate records of purchase and disposal of controlled drugs; purchasing or prescribing any regulated substance in Schedules I through V, as defined by the Uniform Controlled Dangerous Substances Act, for the physician's personal use; and ordering any drug legally classified as a controlled substance for himself.
___ *JOE BOB ALEXANDER, MD – Disciplinary hearing based on allegations of the violation, or attempted violation, direct or indirect, of any of the provisions of the Oklahoma Allopathic Medical and surgical Licensure and Supervision Act, either as a principal, accessor or accomplice; and violating any state or federal law or regulation relating to controlled substances.
___ *CHIGURUPATI RAMANA, MD – Plaintiff's Motion for Continuance; and possible disciplinary hearing based on allegations of failure to maintain a proper office record; failure to provide a proper and safe medical facility setting and qualified assistive personnel for a recognized medical act, including but not limited to an initial in-person patient examination, office surgery, diagnostic service or any other medical procedure or treatment, and medical records to support diagnosis; gross or repeated negligence in the practice of medicine and surgery; being physically or mentally unable to practice medicine and surgery with reasonable skill and safety; practice or other behavior that demonstrates an incapacity or incompetence to practice medicine and surgery; and obtaining any fee by fraud, deceit, or misrepresentation, including fees from Medicare, Medicaid, or insurance.
___ *SAMIYA KHAN, MD – Defendant's Application for Extension of Time; and possible disciplinary hearing based on an allegation of conduct likely to deceive, defraud, or harm the public.
___ *KENNETH ALFRED ROGERS, JR., MD – Disciplinary hearing based on allegations of failure to obtain registration issued by the Director of the Oklahoma State Bureau of Narcotics and Dangerous Drugs; failure to re-register as required by OAC 475:10-1-10; and failure to comply with applicable federal and state laws and regulations with regards to licensing.
___ *BENJAMIN REEDER, PTA – Disciplinary hearing based on allegations of failure to obtain required continuing education units for licensure renewal.
Posted: 3/2/2020 2:54 PM MD Agenda
Susan Chambers, MD, Board President ~ James Brinkworth, MD, Board Vice-President Mr. Clayton Bullard ~ Louis Cox, MD ~ Mark Fixley, MD ~ Mr. Jeremy Hall ~ Mr. Robert Howard ~ Mr. Trevor Nutt
David Vanhooser, MD ~ Ann Warn, MD ~ Don Wilber, MD
4
___ *TRIPTI UCHIL, PT – Disciplinary hearing based on allegations of failure to obtain required continuing education units for licensure renewal.
___ *BRITT JOHNSON, PT – Disciplinary hearing based on allegations of failure to obtain required continuing education units for licensure renewal.
II. UNSCHEDULED ITEMS
___ Review, discussion and possible action – Licensure applications approved via Secretary/circularization (Attachment #1 to agenda)
___ Review, discussion and possible action – Re-registration applications previously approved pursuant to 59 O.S. § 495a.1 (Attachment #2 to agenda)
___ Review, discussion and possible action – Recommendation(s) of Board Secretary regarding re-registration applications pursuant to 59 O.S. § 495a.1 (Attachment #3 to agenda)
___ Review, discussion and possible action – E-Prescribing Waivers previously approved by Board Secretary (Attachment #4 to agenda)
___ Review, discussion and possible action – E-Prescribing Waivers previously denied by Board Secretary (Attachment #5 to agenda)
___ Ratify/approve Committee Recommendations
• Athletic Trainers Advisory Committee • Occupational Therapy Advisory Committee • Physician Assistant Advisory Committee • Advisory Committee on Dietetic Registration • Respiratory Care Advisory Committee • Therapeutic Recreation Committee
___ Review, discussion and possible action – Re-appointment/appointment to the Respiratory Care Advisory Committee for the seat currently held by Melody Beard, RC. The new term is set to expire March 1, 2024.
___ Review, discussion and possible action – Appointment of Medical Board Member to the Advisory Committee on Dietetic Registration to the seat previously held by Lee Schoeffler, MD.
___ Executive Director's report to the Board:
• Review and discussion - Update regarding pending legislation
• Review and discussion – Update regarding Prescription Monitoring Program and Administrative Fines
• Review and discussion – Report regarding Information Technology and Telecom upgrades
Posted: 3/2/2020 2:54 PM MD Agenda
Susan Chambers, MD, Board President ~ James Brinkworth, MD, Board Vice-President Mr. Clayton Bullard ~ Louis Cox, MD ~ Mark Fixley, MD ~ Mr. Jeremy Hall ~ Mr. Robert Howard ~ Mr. Trevor Nutt
David Vanhooser, MD ~ Ann Warn, MD ~ Don Wilber, MD
5
___ New Business – any matter not known about or which reasonably could not have been foreseen prior to the required time of posting
___ Adjournment
March 6, 2020: If needed to complete items on Agenda
Oklahoma State Board of Medical Licensure and Supervision
Licenses Issued From 1/12/2020 To 3/5/2020
Type Number Name License Date
ANA Anesthesiologist Assistant
26 HOLT, JORDAN MICHAEL 01/22/2020
27 RUDDOCK, KLEOPATRA DANIELLE 01/22/2020
AT Licensed Athletic Trainer
857 RIDGE, RACHELLE 01/31/2020
1130 STAFFORD, LAUREN MICHELLE 01/29/2020
1155 SHIN, JEONGHWA 01/31/2020
1157 ACKERSON, LAURIN JOY 01/31/2020
1158 ORTIZ, OSCAR OCTAVIO 01/31/2020
1159 COOVER, CHRISTOPHER THOMAS 01/31/2020
1160 MCKINNEY, STEFAN JORDAN 01/31/2020
1161 FREEZE, TONYA 01/31/2020
1163 HOM, CALVIN MITCHELL BOBBITT 01/31/2020
1164 FRANKS, MATTHEW J 01/31/2020
LD Licensed Dietitian
2040 VOGEL, CASSIDY MARIA 02/13/2020
2201 ATTERBERRY, DAULTON 02/13/2020
2470 MARTINEZ DE LOERA, ROSA MARIA 02/13/2020
2471 STASTNY, ANGELA MARIE 02/13/2020
2472 NEWLIN, SYDNEY BETH 02/13/2020
2474 WALLACE, CHRISTY JEAN 02/13/2020
2476 WALTERS, SERICCA LYNN 02/13/2020
2477 HENRY, WHITNEY LAINE 02/13/2020
2478 BAUMAN, WHITNEY R 02/27/2020
2480 FAIRMAN, MELISSA RABOLD 02/13/2020
2481 PRATER, SARAH LOUISE 02/13/2020
2482 ANDERSON, KENDALL 02/13/2020
2483 JETER, RAYNA 02/13/2020
2484 HANSEN, SARAH 02/13/2020
2485 SHEPPARD, RACHEL 02/13/2020
2487 FORTIN-MILLER, SARA AIDA 02/13/2020
2489 MUIR, NANCY B 02/13/2020
2490 FITZPATRICK, ALEXIS NICOLE 02/13/2020
2492 GRANTHAM, CATHERINE ELISE 02/13/2020
2493 TYSON, KAYLEE NICOLE 02/13/2020
MD MEDICAL DOCTOR
35583 SEROTA, MARCJONATHAN 02/20/2020
35584 GARG, NARENDRA KUMAR 02/25/2020
35585 MARKS, LIANNE 02/13/2020
35586 EMAMI, REZA 02/13/2020
35618 FOLAD, WALLY 02/25/2020
22574 BAXT, BRIAN DAVID 01/16/2020
31512 POLLARD, EMILY MORGAN 01/16/2020
34148 CREMER, STEVEN 02/14/2020
34482 BHARGAVA, DEEPIKA 02/25/2020
34575 SAVIDGE, EMMA ROSE 01/16/2020
35062 LIM, KOK HOO 01/16/2020
35128 MAYDA, JARO II 01/16/2020
35140 BRIGNONI, CATHERINE 02/01/2020
Page 1 of 7Monday, March 2, 2020
Attachment #1
Type Number Name License Date
35160 BRANSKI, LUDWIK KRZYSZTOF 01/16/2020
35199 WITTENBERG, AARON FREDRICK 02/01/2020
35222 CHAUDRY, AYESHA FAWAD 01/29/2020
35225 COURTRIGHT, NAOMI RUTH 02/14/2020
35259 TOLOMEO, CHRISTINA 01/16/2020
35263 ROBINSON-PARKS, ASHA ZAKIYA 02/14/2020
35287 AEILIAS, SWEETY 01/16/2020
35289 BROERING, GREGORY HORTON 02/14/2020
35301 HALL, ERIC LOUIS 02/25/2020
35309 GAO, WEI 02/01/2020
35320 RAMIREZ, CARMEN TERESA 02/01/2020
35323 CAIN, MARTIN WESLEY 02/01/2020
35327 AGNI, GUIRISH ANANT 01/16/2020
35337 IZADPANAH, MARYAM AFSHAR 01/16/2020
35341 ELTELBANY, AHMED SAMIR MOHAMED 01/16/2020
35343 KNAUS, CHRISTOPHER MICHAEL 02/01/2020
35349 SMITH, JAMES WILLIAM 02/25/2020
35355 MIRANDA, KRISTEN ANGELA 01/16/2020
35368 WOLF, STEVEN ERIC 02/25/2020
35371 NORRIS, NATHAN BLAKE 01/16/2020
35375 MCCARTHY, KEVIN FRANCIS 02/01/2020
35376 JALALZAI, WAHEED 02/01/2020
35383 JAGELSKI, AARON T 01/16/2020
35388 KUAN-CELARIER, ANNA 02/14/2020
35392 VARDEY, RAKESH 01/16/2020
35397 PETTIS, CHRISTOPHER RYAN 02/14/2020
35400 FOWLER, MARK J 02/01/2020
35403 MAKIPOUR, TONI LI 02/14/2020
35405 EHANIRE, IMUDIA DEKONTE 01/16/2020
35406 HARRELL, NICHOLAS BRIAN 01/16/2020
35410 KAUR, NIRMAL J 02/14/2020
35411 DESSALEGN, METTY AYELE 01/16/2020
35412 HEUPEL, KAREN ANN 02/01/2020
35413 VERMA, RICHA 02/01/2020
35415 THOMAS, ZINIA SUE 02/14/2020
35417 NEVREKAR, DIPTI VENKATESH 02/01/2020
35420 STRATTON, DWAYNE EVERETTE 02/25/2020
35421 MARTIN, BRETT S 02/25/2020
35423 ARENAS, CARLITO GAVIOLA JR 02/25/2020
35424 DILLON, PAUL LEE 01/16/2020
35430 YENDLURI, PRASOONKUMAR 01/16/2020
35431 CHAUDHRY, RAHMAN MUNIR 02/01/2020
35433 SUN, JEAN 01/16/2020
35435 MOORE, ANNE SCHOLL 02/14/2020
35437 PATEL, JITENBHAI JAGDISHBHAI 02/14/2020
35439 MORROW, KIERNAN HALE 02/14/2020
35440 EGBOH, NENNA N 01/16/2020
35442 THELLA, KOTESWARARAO 01/16/2020
35443 GLASGOW, CORDINE CORRETTA KRYSTAL 02/25/2020
35444 DORNBOS, DAVID LEE III 02/01/2020
35446 WILDE, OLUSEGUN BANKOLE 02/14/2020
35447 OLSEN, AMY HENRY 02/01/2020
35448 HEIDE, AARON CARL 02/01/2020
35449 CHAMARIA, SURBHI 01/16/2020
35450 PADIGALA, POOJA MOHAN 02/25/2020
Page 2 of 7Monday, March 2, 2020
Attachment #1
Type Number Name License Date
35451 ZAMBRANO, JACINTO JR 01/16/2020
35453 WEISS, DAVID BRIAN 02/25/2020
35454 CASH, JONATHAN CHRISTIAN 02/01/2020
35455 FEY, GEOFFREY L 02/01/2020
35456 SPRINGER, RACHAEL 02/01/2020
35458 O'ROURKE, SEAN PATRICK 02/01/2020
35459 MADIREDDI, SUNTHOSH PRADEEP REDDY 02/01/2020
35460 PANDYA, PUNITA SOMNATH 01/16/2020
35462 KRAMER, MARSHALL DAVID 02/25/2020
35463 O'HORO, JOHN CHARLES 02/01/2020
35464 LETZING, MICHAEL ALEXANDER 02/25/2020
35467 PETERSON, JEREMY CHARLES 02/25/2020
35469 HOVELSON, SONIA ANNE 02/01/2020
35470 BOITEAU, GUILLAUME 02/25/2020
35471 ANGADI, VIVEK C 02/25/2020
35472 VALADAO, JASON MATTEO 02/01/2020
35473 VUPPALA, APARNA 02/01/2020
35474 VANDOVER, JOHN 02/01/2020
35475 KRASNE, BENJAMIN HOWARD 02/25/2020
35479 OLJESKI, STEPHEN ANDREW 02/25/2020
35481 SHIKHMAN, ALEKSANDR 02/25/2020
35485 MAHANAYAK, DIBBENDU 02/25/2020
35486 PATEL, NEAL SURENDRA 02/25/2020
35488 GRAVES, MATTHEW JOHN 02/14/2020
35493 CHEEMA, RABIA 02/25/2020
35499 DAS, SMITA 02/14/2020
35501 WEIS, ADINA 02/14/2020
35506 BABER, USMAN 02/25/2020
35509 CALDWELL, BROOKE ALLYSON 02/25/2020
35512 CUFF, THOMAS JONATHAN 02/14/2020
35513 YOUSSEF, HANY LOFTY 02/25/2020
35517 KISER, RYAN MARSHALL 02/25/2020
35518 KNIGHT, KENDRAL R 02/25/2020
35521 JACKSON, QUINN MICHELLE 02/25/2020
35522 FELTNER, JAMI 02/25/2020
35526 MITTELSTET, BETH FEATHER 02/25/2020
35531 HATEM, CARLO MAJID 02/25/2020
35533 YANDELL, DAVID WILLIAM 02/25/2020
35534 SCHNEIDER, NATHAN DAVID 02/25/2020
35541 VERTA, MICHAEL JAMES JR 02/25/2020
35542 FLORIO, DAVID FRANCIS 02/25/2020
35544 PELOQUIN, PETER BUCARO 02/25/2020
35550 PARIKH, RUPIN NITIN 02/25/2020
35559 GEHRIS, ROBIN P. 02/25/2020
35567 LANEY, SAMUEL KEITH 02/25/2020
MD Reinstatement 34637 BARKER, PATRICK NORMAN 02/25/2020 R02/25/20
35395 VICKERY, ROBERTA LUCILLE 02/27/2020
35452 LEE, JEFFREY D 01/22/2020
35494 KASH, DONALD JOSEPH 02/21/2020
35516 CONQUEST, ANNE MARIE 02/11/2020
35527 TAON, MATTHEW CZAR D 02/27/2020
35536 UGWU, DANA CHANELLE 02/27/2020
35551 BERGE, MICHAEL JOHN 02/26/2020
35579 GREGGS, SHARON E 02/26/2020
Page 3 of 7Monday, March 2, 2020
Attachment #1
Type Number Name License Date
OA Occupational Therapy Assistant
2055 FLAKE, BLYTHE 02/19/2020
2119 GOLEMBOSKI, ASPEN B 02/26/2020
2132 ARMENDARIZ, AMY NICOLE 02/07/2020
2141 MILLER, SHANTEL LAREA 01/24/2020
2154 HAFFNER, CLAIRE MARIE 01/14/2020
2163 JOHNSTON, NATALIE GISELE 01/21/2020
2166 WOOD, MELISSA CHEYENNE 02/04/2020
2167 WHITTENBERG, TIFFANY RAE 02/04/2020
2168 SPENCER, STEPHANIE E 02/04/2020
2172 DAVIS, TAYLOR NICOLE 02/12/2020
2173 WATSON, KELSI 02/04/2020
2174 CHRISTIE, SHELBY LYNN 02/26/2020
2175 LONG, CASIE MICHELLE 02/04/2020
2177 TAYLOR, KRISLYN BELLE 02/04/2020
2178 LANGSTON, KENDRA ANN 02/13/2020
2187 MAUPIN, MELISSA ROSE 02/04/2020
OT Occupational Therapist
5400 HUNTER, BARBARA BELLOMO 02/11/2020
5402 HAWKINS, EMILY MARIE 02/04/2020
5403 WILLINGHAM, APRIL 02/04/2020
5404 JONES, CHELSEY HANNAH 02/04/2020
5405 DEO, BHAWNA 02/04/2020
5406 BURRIS, KALIYAH L. 02/04/2020
5407 PARKER, GREGORY RALPH 02/04/2020
5408 FINLEY, HANNAH GRACE 02/04/2020
5409 JONES, JUSTINE L 02/04/2020
5410 MACKEY, TARRYN LORRAINE 02/04/2020
5411 KOENEKE, CARA JO 02/04/2020
5412 NOBLE, AMANDA 02/04/2020
5413 MILES, MICHELE LYNN 02/04/2020
5414 KUYKENDALL, JAIMIE DANIELLE 02/04/2020
5415 LOHMANN, ANDREA CHRISTINE 02/07/2020
5416 MADDOX, DANIELLE RAE 02/04/2020
5418 SEITZ, JESSICA MARIE 02/04/2020
5419 COTTOM, JEROD CLEM 02/04/2020
5420 BROUSSARD, ANDREA L 02/04/2020
5421 DONNDELINGER, KELLY MARIE 02/07/2020
5422 TENNAL, ANNA LEISHA 02/04/2020
5423 POLD, COURTNEY NOELLE 02/04/2020
5424 VINYARD, COURTNEY REY 02/04/2020
5425 GASPAR-FRANCISCO, ANA MARIA 02/04/2020
5427 CLIFTON, KATIE N 02/04/2020
5428 ADAMS, AMBER L 02/06/2020
PA Physician Assistant
3115 RAUN, KATHARINE SMITH 01/22/2020
3134 MATHEW, ANGEL 01/21/2020
3137 VAN DAM, KARLEE CAMPBELL 02/11/2020
3138 BEASLEY, JORDAN 02/11/2020
3139 NEALON, MADISON DALE 02/11/2020
3140 ALBRIGHT, KRISTEN AMANDA 02/11/2020
3141 CLARK, JONATHAN DAVID 02/11/2020
3142 CHASE, HEATHER NICOLE 02/11/2020
3143 NEWSON, JESSICA LYNN 02/11/2020
Page 4 of 7Monday, March 2, 2020
Attachment #1
Type Number Name License Date
3144 ABBOTT, ELIZABETH GAYLE 02/11/2020
3145 SHAFFER, REBECCA LYNN 02/11/2020
3147 LOHMANN, ANDREA CHRISTINE 02/11/2020
3150 GUERRANT, LOUIS 02/11/2020
3151 MEINERT, TIFFANY LOU 02/11/2020
3152 HAYES, MADISON BREANNE 02/11/2020
3153 ROBISON, GRANT AVERY 02/11/2020
3154 PATEL, DEVIKA 02/11/2020
3155 BANT, KATELYN TAYLOR 02/14/2020
3156 JENISON, DORETTA R 02/11/2020
3157 MURPHY, RACHEL MAKANAONALANI 02/11/2020
3158 BENDAVID, KRISTA RENEE 02/11/2020
3159 WILLIAMS, KELSEY LOUISE 02/11/2020
3160 CURRY, JOSHUA SAGE 02/11/2020
3161 RUSSELL, ALLISON ELIZABETH 02/11/2020
3163 APPLE, HANNAH LEA 02/11/2020
3164 BERNAZZOLI, ZACHARY ALAN 02/11/2020
3165 RAMIREZ, ANITA RAQUEL 02/11/2020
3166 LETSHABO, THOBO LESEGO 02/11/2020
3168 ANWAR, AREEBAH MIAN 02/11/2020
3169 LEGG, TIMOTHY ELLIOT 02/11/2020
3176 COBURN, NICOLE ST. AMANT 02/14/2020
3178 CUTHBERTSON, MARK ALAN 02/11/2020
3179 HEATH, ANGELA MICHELE 02/11/2020
PD Provisionally Licensed Dietitian
781 CHAMBERS, BAILEY KAY 02/13/2020
782 MARSH, AUBREY CAROL 02/26/2020
785 DOUGAN, KEIRA ALAYNE 02/13/2020
788 DIAZ DE LEON, JASMINE IRENE 02/13/2020
PR Provisional Respiratory Care Practitioner
1943 ECK, KYSHA LYN 02/18/2020
1944 ROBINSON, TANNER 02/18/2020
1945 NEWTON, MAYESHAH 02/18/2020
1947 RODRIGUEZ, KARLA ARELI 02/18/2020
1948 TOYEBO, JESSICA NEMAH 02/18/2020
1949 BROWN, RHYAN S 02/18/2020
1950 GUILLETTE, GANESA LYNNE 02/18/2020
1951 OVERSTREET, CORI BETH 02/18/2020
1952 BATTLES, LOREN HOPE 02/18/2020
PT Physical Therapist
5599 MORRIS, BRIAN CHRISTOPHER 02/06/2020
5706 OGG, MATTHEW DILLON 02/19/2020
5719 WORLEY, DAN 02/01/2020
5774 KETTNER, JACOB 02/01/2020
5775 TAYLOR, KENZI ELIZABETH 02/07/2020
5777 STUART, MADDI 02/07/2020
5779 NEUFELD, MATTHEW WILLIAM 01/13/2020
5782 SULAIMAN, SALMA 02/01/2020
5783 MARTIN, JON-ANDREW 02/07/2020
5784 DEMOSS, JUSTIN CORD 02/07/2020
5787 BUXTON, DELIA ABANO 02/03/2020
5790 CUNNINGHAM, KATIE 02/01/2020
5791 KERLEY, HAYLEY 02/07/2020
Page 5 of 7Monday, March 2, 2020
Attachment #1
Type Number Name License Date
5792 SAVAGE, BRIA IMAN 02/01/2020
5793 CAROTHERS, ROMAN DAVID 02/07/2020
5794 WEBER, JOSEPH COLE 02/07/2020
5798 MCMASTER, TAYLOR NICOLE 02/01/2020
5800 ENGEL, SERENA MICHELLE 01/21/2020
5802 SULLIVAN, PATRICK RYAN 01/21/2020
5803 WEICHSELBAUMER, MARIANNE CAROLINA 01/21/2020
5805 HENRY, COLTON 02/01/2020
5806 HOWE, ZACHARY 02/07/2020
RC Respiratory Care Practitioner
4897 RILEY, HEATHER MARIE 02/18/2020
4963 SHEPARD, ANGELA MARIE 02/18/2020
4993 CHOATE, TARA ANN 02/06/2020
5054 LOOPER, KATHERINE RENEE 01/13/2020
5065 DAUPHIN, BETSY ANN 01/30/2020
5066 COX, DAVID LEE 02/13/2020
5075 MARTIN, ERIN CORINNE 02/18/2020
5076 SMITH, BRITTNEY RENEE 02/18/2020
5077 MILLER, JAILON 02/18/2020
5078 LUND, EMILY MICHELE 02/18/2020
5079 DANH, SABRINA A. 02/18/2020
5080 DUNHAM, QORTNEE LEE 02/18/2020
5081 PEARSON, DARRELL LIEUVERN 02/18/2020
5082 WINDSOR, JENNIFER ANN 02/18/2020
5083 LOR, NAO TOUA 02/18/2020
5084 ROE, CARLIE BROOKE 02/18/2020
5085 HEMMINGSEN, NICOLE JANE 02/18/2020
5086 HUDSON, MADELINE E 02/18/2020
5088 MARTINEZ, GLORIA DE JESUS 02/18/2020
5089 TREVINO-CRUZ, BEATRIZ 02/18/2020
5090 LAASCH, LINDSEY RAE 02/18/2020
5091 BATEMAN, CRYSTAL YUVONNA 02/18/2020
5092 PEOPLES, NYELA MARIE 02/18/2020
5093 PARENTI, AMANDA LEA 02/18/2020
5094 BOSTICK, CINTERRIA RENA 02/18/2020
5095 GUAJARDO, NICOLE MARIE 02/18/2020
5096 HENSLEY, RYAN STEPHEN 02/18/2020
5097 DIAZ, GETSEMANI 02/18/2020
5098 BROWN, KATHERINE MARIA 02/18/2020
5099 CRITTENDEN, JAZZMINE RODNIESHA 02/18/2020
5100 DENSON, ADRIAN THOMAS 02/18/2020
5101 CRAWFORD, SHARON 02/18/2020
5102 PARKS, RACHEL CHRISTINE 02/18/2020
5103 ARTEAGA, KATRINA MARIE 02/18/2020
5104 NGUYEN, ANTHONY 02/18/2020
5105 BELL, CHEMELLE DERAE 02/18/2020
5106 RICHARDSON, KALYN R 02/18/2020
5107 CLOUSE, BRIAN JOHN 02/18/2020
5108 DO, PETER THIENAN 02/18/2020
5109 ROMAN-RAMIREZ, SAUL 02/18/2020
5110 ERB, BRIANA SUE 02/18/2020
5113 VALDEZ, JON-JAYMES LAGO 02/18/2020
5116 ROGERS, JOSHUA WAYNE 02/18/2020
5117 NGUYEN, AMY MINH 02/18/2020
5118 SAUCEDO-CRUZ, DARIAN 02/18/2020
Page 6 of 7Monday, March 2, 2020
Attachment #1
Type Number Name License Date
TA Physical Therapist Assistant
2885 LONG, KAYLEE LYNN 02/01/2020
3185 PROCASKY, TAYLOR 02/01/2020
3200 BUCKMASTER, JAYCEE ROSE 02/01/2020
3201 STOUT, DAVID 01/17/2020
3203 BROWN, HAYLEY MARIE 01/17/2020
3204 MURRAY, NICOLE OLIVIA 02/01/2020
3210 YEAGER, SHEENA KAY 01/17/2020
3211 JONES, JONATHAN D 02/01/2020
3213 THOMPSON, TIFFANY NICHOLE 01/17/2020
3214 MARTINEZ, CASSIE RANEE 02/01/2020
3215 BUTLER, BROOKE CHRISTEN 01/21/2020
3217 HAWORTH, KYLE PATRICK 02/01/2020
3218 JONES, HALEY BREANN 01/17/2020
3220 DUANE, RAELENE 02/19/2020
TRS Therapeutic Recreation Specialist
219 GALIER, VICTORIA C 02/12/2020
220 FOWLER, MCKENZIE RYAN 01/13/2020
Page 7 of 7Monday, March 2, 2020
Attachment #1
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Attachment #2
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56
Pa
ge
11
of
12
Attachment #2
Lic
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Lic
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Lic
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e
ME
RE
DIT
H
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S
24
63
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2
70
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JO
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14
44
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ER
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KIM
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16
01
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AT
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29
98
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ON
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19
15
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CE
RU
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1
51
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4
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9
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1
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1
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27
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17
21
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1
97
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26
77
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19
21
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22
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R 4
01
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6
29
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6
04
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Care
Pra
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ne
rB
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4
08
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4
72
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9
43
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2
67
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33
50
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LO
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AN
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1
00
0
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71
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43
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4
23
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D
95
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37
15
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RG
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93
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3
02
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J.
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OK
9
86
BR
AN
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RE
NA
E C
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PE
R
33
57
KIM
BE
RLY
SU
E C
OZ
OR
T
26
81
CR
YS
TE
L D
AW
N C
RA
NO
R
30
24
TO
NY
A M
ICH
EL
LE
CR
INE
R
26
19
DE
E A
NN
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G
14
74
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NN
IFE
R A
PR
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EN
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RT
3
36
6
MIR
AN
DA
LY
NN
DA
VIS
4
38
3T
IFF
AN
Y J
EN
EA
DIX
ON
3
36
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AU
RIE
AN
N D
OR
SE
Y
47
27
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EP
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AN
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LE
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47
32
DA
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RA
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DU
MA
NA
S
43
67
DO
NN
A C
AT
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CA
N
96
9
FR
AN
K M
AR
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DU
NN
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9
70
AN
GE
LA
LE
E E
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KS
EN
4
71
8B
RA
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OL
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NS
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RT
H
33
52
MIC
HE
LL
E A
NN
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FE
RG
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2
67
0A
NG
EL
IQU
E M
AR
GR
ET
FO
RB
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3
03
4G
AIL
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N F
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Z
25
61
JUL
IE D
IAN
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AV
IN-W
AD
E
90
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RA
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WN
GR
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G
12
92
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IRL
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1
47
8
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AE
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4
39
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36
98
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A
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4
73
4
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8
69
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26
74
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9
54
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AR
PS
4
35
9D
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AR
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AR
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9
41
JE
RE
MIA
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3
36
0
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ILE
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2
67
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SI
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AIN
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3
70
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NG
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A M
ICH
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RY
3
68
9
MA
RV
IN D
EA
N H
EW
ITT
3
04
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LIS
ON
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AIN
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ILL
37
13
QU
INN
LO
UA
NN
HO
WA
RD
1
46
8
JIL
LIA
N R
HU
NT
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AN
3
69
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SL
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SO
N
30
17
RY
AN
DE
L J
AC
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ON
2
66
5
MIC
HA
EL R
AN
DO
LP
H K
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LE
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43
98
AN
ITA
JU
NE
KN
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9
78
SH
AR
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LY
NN
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9
74
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1
47
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LA
MB
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43
60
LIN
DS
Y N
ICO
LE
LA
ND
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M
21
24
GE
RA
RD
RE
GIN
AL
D L
AN
GO
C
14
79
GA
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AN
OY
3
35
5S
TE
VE
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LE
3
70
9
SA
LLY
DE
NIS
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EW
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86
1M
AR
ISS
A G
AIL
LO
TT
4
07
4K
EV
IN T
OD
D L
OW
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Y
26
49
AN
DR
EA
KA
E M
AR
TIN
3
72
1R
OG
ER
DE
AN
MA
ST
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S
87
3D
AV
ID A
LA
N M
AY
3
70
0
LA
FO
ND
A R
MC
CA
BE
3
01
5M
OL
LI
CL
AR
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CK
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4
51
4S
TA
CI
LE
AN
NE
MC
MA
ST
ER
2
32
0
JUA
N C
AR
LO
S M
EN
DO
ZA
9
03
SH
AM
IKA
DE
SH
AW
N M
ILL
ER
4
07
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ON
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8
84
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30
16
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N
43
63
RO
SA
NN
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RI
MIC
HE
LL
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R
33
59
JEN
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ER
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S
40
75
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NIF
ER
MA
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MU
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LE
R
30
37
BR
IAN
NA
DE
SH
AW
N M
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4
72
4
BR
EN
DA
M
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S
96
2JE
NN
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NN
NA
TIO
NS
3
68
4S
HA
OX
IAN
N
EA
LE
4
36
9
GE
NE
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MA
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36
81
JER
RY
DO
UG
NE
LS
ON
2
114
MIA
N
GU
YE
N
37
20
SY
DN
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PA
IGE
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EN
S
43
75
EL
IZA
BE
TH
MA
RIE
PA
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4
39
9K
EL
LY K
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PE
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R
10
61
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4
36
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A
91
0
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RC
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1
48
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IN A
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30
14
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RB
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30
48
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ME
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4
06
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9
68
KR
IST
IN D
AN
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LE
RO
DG
ER
S
43
85
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TU
M A
NN
RO
E
40
80
KE
LIS
HA
AN
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S-E
ST
RA
DA
4
39
1H
EL
EN
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AIN
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KS
1
01
2
RO
CK
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ILL
IAM
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PE
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9
95
RA
CH
EL M
AL
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3
02
7JE
RR
Y J
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MA
N
43
81
JES
SIC
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CH
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3
02
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ISS
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2
09
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9
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26
78
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37
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14
66
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36
88
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38
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34
6
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4
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43
84
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40
73
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14
85
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3
69
2V
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47
23
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40
63
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03
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47
20
AN
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CH
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A
37
05
AN
TO
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NA
TH
AN
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RF
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D
30
45
LA
NC
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OB
ER
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SO
N
99
7
HO
LLY
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NE
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LA
ND
2
68
3L
ISA
LA
DA
WN
WE
ST
BR
OO
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14
88
AA
RO
N A
LL
AN
WH
ITE
1
03
0
TO
BY
CA
RD
EL
L W
ILL
IAM
S
26
85
DE
NIS
E
WO
RK
MA
N
90
8D
AN
IEL M
CN
AIR
WY
LY
30
20
CH
RIS
TIN
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AB
ET
H W
YN
N
21
08
CO
NN
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CO
RN
EL
IA)
HE
LE
NE
YA
RN
EL
L
10
31
JE
FF
RE
Y J
AM
OR
A Y
OU
NG
9
89
Pa
ge
12
of
12
Attachment #2
Bo
ard
Secre
tary
Rec
om
me
nd
ati
on
s f
or
Re
-Re
gis
tra
tio
n A
pp
lic
ati
on
s f
rom
1/1
4/2
02
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o 3
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ma
Sta
te B
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f M
ed
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l L
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ns
ure
an
d S
up
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n
Lic
#L
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see N
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Lic
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see N
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Lic
en
see N
am
e
ME
DIC
AL
DO
CT
OR
DO
NA
LD
CA
RY
BL
AK
E
27
48
5B
RA
ND
ON
BE
NJA
MIN
BO
KE
2
54
77
MA
RIA
IU
LIA
NA
BO
TE
Z
24
30
5T
RO
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INS
LE
Y C
AL
DW
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L
24
33
6D
AV
ID F
RA
NK
LIN
CA
WT
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N
33
56
6A
ND
RE
W L
UK
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HA
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2
94
28
AR
TH
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HO
BA
RT
CO
NL
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III
21
47
6D
AR
RE
L W
AY
NE
DO
DS
ON
3
03
19
JA
ME
S L
AW
RE
NC
E F
LE
CK
EN
ST
EIN
2
32
88
DA
VID
L G
RA
HA
M
20
60
1P
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N H
AN
2
48
86
TO
NY
HU
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QU
AN
HO
1
16
54
DA
VID
L
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3
45
83
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TH
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LIN
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3
36
85
WA
JIH
A
MA
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3
42
69
RO
NA
LD
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3
04
23
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M
MA
RC
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26
011
MIC
HA
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27
58
6JE
NN
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MA
TH
EW
3
47
28
SC
OT
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1
96
58
STA
NL
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J.
NY
AR
KO
2
77
71
MO
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D H
AS
SA
N O
SS
IAN
I 2
55
20
AT
IF
SO
HA
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21
05
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AU
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ES
3
111
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SE
PH
U
NG
AR
3
45
58
RE
BE
CC
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3
12
68
JA
SO
N L
LO
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2
96
55
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WR
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2
48
90
Ph
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al T
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pis
tJA
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DW
IN
52
51
SH
AN
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46
43
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14
89
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ILY
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TH
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L
111
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ITT
4
24
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2
81
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15
29
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30
64
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2
33
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29
52
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40
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IZA
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22
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14
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21
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TE
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3
15
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73
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. B
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RY
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23
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63
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3
15
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RO
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29
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DY
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ISH
1
61
7B
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TT
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NA
TH
AN
BE
NN
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T
99
9H
ILL
AR
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NN
BE
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T
29
64
NA
TA
LIE
LL
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EL
LYN
BE
NN
ET
T
111
6C
OL
IN O
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BE
RG
ER
ON
3
01
4M
AT
TH
EW
ST
EV
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BE
RT
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8
61
AS
HL
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WN
BIG
GS
1
91
4K
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BIR
CH
1
73
4JE
NN
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S
21
76
KIM
BE
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Pa
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4 o
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Attachment #3
Lic
#L
icen
see N
am
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ic#
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see N
am
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see N
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e
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88
Pa
ge
5 o
f 5
Attachment #3
Electronic Prescribing Waivers Approved
01/15/20 - 03/01/20Oklahoma State Board of Medical Licensure & Supervision
MD PERKINS, JOHN10570 MD DAWOD, ABDALLAH24330 MD NOORI, DARIUS21921MD ANUKAM, UZOESHI35396 MD BHANOT, AKSHEY28257 MD CHUNDRU, VITTAL30627PA CLICK, JAMES406 PA CLICK, JAMES406 MD HARRELL, NICHOLAS35406
MD JAGELSKI, AARON35383 MD MIHANNI, ASHRAF16578 MD RESNEDER, JOHN12326MD JIA, GREGORY19082 MD XIONG, YAN29370 MD YEABOWER, JOHN16043MD LOPEZ, MARTIN16998 MD MERRITT, JOSEPH15108 MD YEABOWER, JOHN16043MD TAYLOR, CHARLES9047 MD TAYLOR, CHARLES9047 MD VAN TUYL, CHARLES16535MD DIMICK, SUSAN15279 MD AMUNDSEN, GERALD20242 MD CLEMENTS, MELISSA14621MD DIMICK, SUSAN15279 MD HANLEY, BRIAN35370 MD KELLY, STEPHEN21242MD MAAN, WAJIHA34269 MD ROCKLER, BARRY13073 MD GAWEY, ELIZABETH18603PA MARLOW, TIMOTHY892 MD MCCLAIN, RICHARD18904 MD MITCHELL, GREGORY16334
MD BREWER, JONATHAN20530 MD KAISER, TIMOTHY23829 MD SNELL, STEPHEN19315
Total Waivers Approved: 36
Page 1 of 1
Attachment #4
Electronic Prescribing Waivers Denied
1/14/2020 - 3/1/2020
Oklahoma State Board of Medical Licensure & Supervision
LicenseApplication
DeniedLicensee Name
1/22/2020PA A'BELLE, N464
1/15/2020MD BIEHLER, LARRY7931
2/2/2020PA BLUETHMAN, RANDY404
2/2/2020MD GOROSPE, LUIS10249
2/6/2020MD GREGORY, JAY13585
1/22/2020MD HORTON, SAM22025
1/16/2020MD JAMES, JENNIFER29235
2/18/2020MD JIA, GREGORY19082
2/27/2020MD KATTA, SRINIVAS MAHESH30949
1/10/2020PA LAMBERT, LAUREN2925
2/18/2020MD LOPEZ, MARTIN16998
1/17/2020MD PARACHA, MOHAMMAD21878
2/26/2020MD RODRIGUEZ CUADRADO, GLORIA34159
1/14/2020PA SMITH, SANDRA1929
1/10/2020MD SULTAN, MAHA18737
1/10/2020MD TAYLOR, CHARLES9047
1/14/2020MD THANOU, AIKATERINI25282
1/14/2020PA WADLEY, CORI1519
1/22/2020MD ZANDI, FARSHID22558
Total Waivers Denied: 19
Page 1 of 1
Attachment #5
