GEORGIA COMPOSITE MEDICAL BOARD · William Butler, MD, Medical Director Carl Bedingfield, ......

Georgia Composite Medical Board

Minutes of the December 7, 2017 Meeting

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The Georgia Composite Medical Board (GCMB) held its regular meeting on December 7, 2017 at

2 Peachtree St. NW, Atlanta, Georgia, to consider Medical Board matters.

Board members present:

John S. Antalis, MD, Chair

E. Daniel DeLoach, MD, Vice Chair

Keisha Callins, MD, MPH

Gretchen Collins, MD

John Downey, DO

Charmaine Faucher, PA-C (ex-officio)

Alexander S. Gross, MD

Rob Law, CFA

J. Jeffrey Marshall, MD

B. K. Mohan, MD

David Retterbush, MD

Joe Sam Robinson, MD

Barby Simmons, DO

Ronald “Ronnie” Wallace, MBA

Richard Weil, MD

Management and legal staff present:

LaSharn Hughes, MBA, Interim Executive Director

William Butler, MD, Medical Director

Carl Bedingfield, MD, Assistant Medical Director

Tara Burks, Business Analyst III

Karl Reimers, Director of Investigation

Patricia Sherman, Enforcement Manager

David Stubins, Senior Assistant Attorney General

Phyllis White, Director of Special Projects

Doris Williams-McNeely, Senior Assistant Attorney General

Janet Wray, Senior Assistant Attorney General

Joanna Zackery, Licensure Manager

CALL TO ORDER

Dr. DeLoach called the meeting of the Georgia Composite Medical Board to order at 7:30 a.m.

AGENDA AND MINUTES

Dr. Weil submitted a motion, seconded by Dr. Robinson, to approve the agenda of the December

7, 2017 meeting. The motion carried unanimously.

Dr. Retterbush submitted a motion, seconded by Dr. Marshall, to approve the minutes of the

November 2, 2017 meeting. The motion carried unanimously.

CHAIR’S REPORT

Dr. DeLoach discussed the following items with the Board:

1. After reviewing the Board meeting dates for 2018 Dr. Weil motioned to approve the

dates. Dr. Robinson seconded the motion and it carried unanimously.

INTERIM EXECUTIVE DIRECTOR’S REPORT

Ms. Hughes presented the report. The Board took the following actions:

LaSharn Hughes, Interim Executive Director introduced the Joanna Zackery, new Licensure

Manager.



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1. Board reviewed a rough draft of the Annual report to provide comments.

2. An article entitled “Healers are dealers?” by Carrie Teegardin. For information only.

APPEARANCE

Kiley Hodge, Georgia Society for Respiratory Care met with the Board to explain the reasoning

behind Rule 360-13-.01., and to express concern. Janet Wray, Assistant Attorney General and

Gretchen Collins, M.D., Board member gave statements regarding the requirements pertaining

to licensure with a RCP and/or the CRT exam.

Dr. Retterbush motioned to send the rule back to the Rules Committee for consideration. Dr.

Marshall seconded the motion and it carried unanimously.

AMA UPDATE

Dr. Antalis attended the AMA meting and gave a brief report on the meeting to the Board.

RECOGNATION

The Board thanked Janet Wray, Senior Attorney General for her years of service and dedication

to the Board.

RECONVENE INTERIM EXECUTIVE DIRECTOR REPORT

1. Michele Madison, Moore, Manning & Martin, LLP requested a Declaratory Statement

regarding an arrangement with NewCo opening own office space, employ non-

professional staff and maintain contracts to provide supplies to a medical practice in

exchange for a fee. Is this permissible under the Patient Self – Referral Act. Board to

refer to Attorney General’s office for advice and response.

2. Helen Souders emailed with questions concerning licensure requirement for plasma rich

platelet, PRP injections. Who can and cannot inject PRP in Georgia. Refer to the Rules

Committee for their consideration of Rules.

3. A request from Andrew W. Neubeckr, CPT, MS Commanding, regarding licensure

information. Inform him the Board can provide standard information which does not

include date of birth and other personal information.

4. Helen Robinson sent information and summary regarding her presentation to the Board

in November. For information only.

ATTORNEY GENERAL REPORT

Janet Wray, Senior Assistant Attorney General, presented Board orders received for Coral

Rochelle Benge PA, and James Frederick McGuckin, MD.



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Dr. Retterbush motioned to accept the Board orders as presented. Dr. Marshall seconded the

motion and it carried unanimously.

Janet Wray, Senior Assistant Attorney General gave a presentation regarding Board protocols,

licensing procedures, enforcement, and Board member recusals.

RECONVENED INTERIM EXECUTIVE DIRECTOR REPORT

6. Letter from Kayln Lane regarding prescribing of controlled substances based on

telemedicine appointments, NP Protocols, and controlled substances.

7. The Federation of State Medical Boards regarding the new proposed location of the

advocacy office in Washington DC. For information only.

8. Reviewed highlights from the Federation of State Medical Board, Board of Directors

Meeting October 25-27, 2017. For information only.

9. Article – “Intensive Program for addicted doctors shows results.” Washington Post. For

information only.

10. Work Group Meeting to Develop the “Georgia Opiod Response Strategic Plan.” Ms.

Hughes and Mr. Reimers will attend on behalf of Board. For information only.

11. Ms. Hughes gave a briefing concerning the Board budget.

Dr. Weil motioned to go into closed session. Dr. Robinson seconded the motion and it carried

unanimously.

Dr. Deloach declared open session.

12. Ms. Williams-Neely, Senior Assistant Attorney General sent an email regarding the

future of Vanderbilt Forensic Psychiatry Services. Board approved to notify

Vanderbilt Forensic Psychiatry Services they will no longer be on the Board’s list for

peer reviews.

Dr. Downey motioned to go into closed session. Dr. Robinson seconded the motion and it

carried unanimously.

Dr. DeLoach declared open session.

Dr. Gross motioned to seek an expedited hearing for investigative file No. 20161239. Dr.

Retterbush seconded the motion and it carried. Dr. Antalis recused.



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RECESS

Dr. DeLoach declared the meeting in recess for the purpose of holding committee meetings.

RECONVENE

Dr. DeLoach reconvened the meeting at 1:30 p.m.

Dr. Gross motioned to go into closed session to discuss investigative matters. Dr. Robertson

seconded the motion and it carried unanimously

Dr. Deloach declared the meeting in open session.

NURSE PROTOCOL COMMITTEE

Dr. Callins presented the Nurse Protocol Committee report as a motion. Dr. Retterbush seconded

the motion. The Board accepted the report by unanimous vote.

The Board took the following actions:

Determined that the following protocol agreements meet the provision of OCGA 43-34-25.

APRN Last APRN First Middle Supervising Physician

Adams Elizabeth Jamie Sofia Munir, MD.

Adjei Vincentia Ijeoma Azonobi

ANDERSON MELISSA MARIMARIE JOHN AICHER MD

Angevine Margaret Atishi D. Aggarwal, MD.

Armstrong Kendra P. Alan K. Brown

ATKINS BETHANY JEFFERY BUTLER MD

Austin Yashica Charles Jackson, MD

Azike Nkechi Malaika Berkley , MD

Bailey Jana Wilson Patricia H. Meadors

BAILEY MARY JONATHAN WADE MD

Bain Judy Brooks David Eric Jones, MD

Baker Nikisha John Schuler, MD

Baker Charissa Faith Mark P.Rheaume, MD.

Baldy Angela R. Alan G.Getts, MD.

BARBER KALLI JEFFREY HARRIS MD

Barco Angela M. Douglas W. Johnaon, MD.

Barkhouse Jeffrey Kennon McLendon, MD

Barnes STACEY CHARITY WILSON MD

Barnes Esther Marie Erin Dvis London, MD.

BARROW MICHAEL RICHARD MARK LEE MD

BEAUMONT LANE CHERYL PERKINS MD

Beecher Sarah Renae Jocelyn Grunwell, MD



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Belflower Crystal M. Terry Eugene Ham, MD.

BELL COSETTE ODOM JON GIBBS MD

Benoit TERESA ISRAEL BRYSON MD

Benoit Cornelia Cherilyn Zellner

BERRY JENNIFER PETERS ERIN CANNINGTON MD

Boles Shaheedah Micheal Anthony Burke, MD.

Booker Erin R. Amar V. Mohan, MD.

Boone Lashawn Kay Vita L. Goei, MD.

Bouchard Anna Rishi Gupta, MD.

BOULWARE ANGEL KHALID HAYAT MD

Boyett Susan Darlene Linda K. Hudson, MD

Boyette Kelly Timothy McGlaughlin, DO.

Brackett Robin Rosman Shrestha, MD

BRILL NATALIE ROGER SIMON MD

Brookington Felecia Walton Jame Harrell, MD.

Brown Amber Timothy P. Villegas, MD

Brown Cynthia M. Randolph Martin Capocasalg, MD.

BROWN DARLENE TURNER MICHAEL SWANEY MD

Bryan Shawneka Denise Naila Denise Avery, MD.

Bryan Shawneka D. Khalid J.Hayat, MD.

BRYANT BETH OI-WAH YAP MD

BRYANT CHARLES JONATHAN WILLIAMS DO

Bulfinch Idica Stacey Anne Todd Dallas Cable, MD.

BULLARD ERICA ANN ALESIA FLEMING MD

BURLESON VALENCIA SCOTT WAGUESPACK MD

BURSEY LAUREN GEETER LINDA MOORE MD

Bussey Melanie Ann Maria Juahar, MD.

BYARS TERRI DAVE TOMEY MD

CADLE HARRIET EYVONNE EDUARD MONANA - MD

Campbell Jimmy Rex Moneer Sohail, MD.

Cannington Michelle Nguyen Thinh, MD

CAREY ANNA GIRISH ANAND MD

Carman Catherine Michael Moody

Carstarphen Tracy Andrea Muhammad Ahmed, MD.

CARTER AMY BARRY IGUOBADIA MD

Carter-Harbin Mary James Douglas, MD

Castano Olga Lucia Marc G. Amaya, MD.

Castro Brittany Benjamin Harris Holland, MD.

Cayton Teresa U. Thomas J. Ferrari, MD.

Chandler Michelle Ellen Ashok Satty Reddy, MD.

CHAPMAN PATRICIA EDWIN HENDRICKS JR DO



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Chastain Mary Elizabeth Ravin Talati, MD

Clancy Allison Paige Karen Hallermeier Watson, MD

CLARK KATHLEEN LINTON WILLIAM STUART MD

CLARK CASEY DANIEL VIJAY THILLAINATHAN MD

Cole Allyson Mae Peter Wrobel, MD.

Cole Charles Robert Daniel Martin, MD.

Collins Nancy Danielle Eric Buckley Anderson, MD

Colston Candace Lynn Kerry Wagel, DO

COMBS JENNA MICHAEL METRY MD

Compaan Kyle Frank Buese, MD.

Conn Danielle Taryn James O'Shea Timothy, MD.

Connie June Barnett Ogechi Helen Mbakwe, MD.

Cook Patricia Christina M. Kile

Cook-McKnight Crystal Raini Ian Davis, MD.

Cord Francesca M Jeffery Eliason, MD

Cordero Gloria Denise Musharaf Momin, MD.

Cothern Stephanie Lorett D. Duggan, MD.

Cothran Deborah C John Inman III, MD

Cowgill Bryce Simpson Thomas DeMartini, MD.

Cox Sheryl Turner Bruce Gioia, MD

CREEL KIMBERLY DAWN KIMBERLY HARBIN MD

Cross-Robinson Anicia Bordica David Albert Fields, MD.

Crump Christie Ray Robert Harriosn Hummer lll, MD.

CULPA-BONDAL MARIA RICHARD ELLIOTT MD

CURRIE MEKINNAH RAE SRIINAND MANDYAM MD

CURRY DAVID TONY ROWE MD

Cutter Shibana Toney Clark, MD

DANIEL MILA MICHELE ELLIOT RAIZES MD

Daniels Rebecca Grace Brandon Kemp Hicks, MD.

Dasher Ashley Kessler Claude Levon, lll Sanks, MD.

Davis Eleanor Sharon John S. Inman, MD.

Davis Michelle M. Linda Katherine Hudson, MD.

Denmark Callie Stewart Hal Scherz, MD.

Dexter Susan E. Gary M.Daniels, MD.

DILLER JEFFREY MARC AMAYA MD

Dimmerling Miranda Olivia Jenny Grossman, MD.

Donaldson Thera Jean Frederico B. Palacio, MD.

DORMIO JEANETTE DAVID KNUZ MD

Doyal Shannon A. Raymond C. McKoy, DO

Doyle Ronnie Vingle McEver lll, MD

Dugas Princess Marie Wayne Bernard Harris, MD.



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DUNMIRE KAREN ELIZABETH MOHAMMAD OSMAN MD

Durane Diana Claire Mac Andrew Bowman, MD.

DuVall Caroline Lee Gerald McCormick, DO

DWIGHT III WILLIAM MFON INYANG MD

DYKES ASHLEY JORDAN MARY BELL VAUGHN MD

Edenfield Monica Thomas Zickgraf, DO

EDENFIELD MONICA THOMAS ZICKGRAF DO

Edmond Donna Marie Fioias DeLeon, MD

EDWARDS MICHELE LEE SONJOY LASKAR MD

Egbufoama Jane Edward Minor, MD.

EJIFOMA MARY BOBBY KHAN MD

Elam Adrian Denise Alvin Jackson, MD

Eldred Susan Elaine Martin L. Austin, MD.

Ellis Kameelah L Nidhi Khanna, DO

Evans Paula Peter Resnick, MD

Fass Alexandra John Layher

FEEHAN MAGEN BOOKER DALTON MD

Felser Carole Felice Amy E.Gonzalez, MD.

Fields Denise Michele Tarsem Lal Gupta, MD.

Filkins Timothy Malini Reddy

Fincher Miranda Micheal Satchell, MD.

FINNERTY ALISON ATUL KHURANA MD

Fisler Rene N. Michele M. McMahon, MD

Flategraff Nancy Alvin Jackson, MD

FLORY TRACY TAKIA OGLESBY MD

Ford Patricia Carol Christina Kile

FORMAN ANNA CHRISTOPHER MEDURI MD

Forrest Kelly Antion James Braswell White, MD.

Francois Lise-Stephana Nadia D. Taylor, MD.

fry Alexander Charles Moore, MD

Fuller Wendy S. Kwon S.Choe, MD.

GACUSAN MYRNA MADHAVI RAYAPUDI MD

Gaddis Stephanie Black Alan D. Justice, MD.

GALLEGOS MERRISSA DAVID NAJJAR MD

Garrett Jr. Robert Carlton Christopher Inhulsen, MD.

Garrison Margarita William Snell, DO

GIBBS ASHLEY SUDHA REDDY MD

GILLEY ASHLEY HEATHER JACQUELIN MILLER MD

GIRODO ELEANOR HOLLY KRYSIAK MD

Gladden Brandi Nichole Damon Christian Kimes, MD.

Goba Nballu Melina Janardhanam, MD



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Gordon Fricke Susan Lynn Richard L. Brandon,MD.

Gorgens Ulrike Hui-Kuo Shu, MD.PHD

GOSIER ENDIA CLAY LEE DO

Graves Dellinia Ram Reddy, MD

Green Angella D. Bennie Bret Law, MD.

GRIGSBY JOHN GEORGE GARRISS MD

GRILLO MACKENZIE JOSHUA WILLIS MD

Gross Josyln Lillian Rohit Panchal, MD.

GROVE LINDSAY REGINALD DAVIS MD

Hall Lynette G. Lawrence D. Powell, MD.

Hamlin Amy L. Christina Oskins, MD.

Hammock Lisa Ann Onkar Kaur, MD.

Hancock Crystal Ted Scoggin, MD

HANEY DANIEL JAYMAL PATEL MD

Hanse Megan Michelle Erin Davis London

Harguess Penny L. Frank G.Lake lll

Harper Amber Rose John Houser, MD.

Harpold Scott Kancharla Ashok

Harris Heather Patricia Moody, MD

Harris Lisa M. Eugene Yo-Jen Sun, MD.

HARRIS KIM TAMMIE QUEST MD

Harrison Shirley Dianne Cherilyn Zellner, MD

HARRISON MARY DAVID STAHURA DO

Hart Kimberly Smar Shah, MD

HASS KRISTEN SOOKYONG KOH MD

Hasty Angel Brooke Alicia Weksler

HAWKLAND ROBIN ANN JONATHON MOLNAR MD

Headley Craig Robert Del Pozo, MD

Helton Rebecca Jeuslyn Chandler, MD.

HELTON REBECCA JEUSLYN CHANDLER MD

Helton Tamika L. William O. Ranleine Jr., DO.

Henderson Haley Mcginnis Caroline Du Yaphockun, MD.

Henderson Susan Vanderlyn A. Sewell, MD.

Hernandez Odessa Brooke Gedrick, MD

Hernandez Odessa Chinedum Clark, MD

Herrick Amy Shahin Chowdhury

Herrin Sara Anitra Howard Silk, MD

Herring Tracy Adedapo Odetoyinbo, MD

Hickman Dana H. Swachitha Kothanpally, MD.

Hinton Cindy Scott Shelfo, MD

Holley Nelda Darlene Khudar Burjak, MD.



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HOOK COURTNEY TRARCY GREENE-JOHNSON MD

HORTON BRIAN ANDREW Darius K Brown, DO

House Scarlett Marie David Campbell, MD

HOWARD LINDSEY MARK GRIFFITHS MD

Hudson Kelly Krueglet Sofia R. Munir, MD.

HUH JIN STEVEN BRADLEY DO

Hung Sylvia Shwu-Yea Herschel W. Smith lll

Hutto Lyndsey Jonothan Allen, MD

Hutto LyndseyT. Allen Jonathon, MD.

Igbinoba Shanna-kaye Adesuwa Miles Johnson, MD.

IVEY KAREN BELINDA DIVYA NARAYANASWAMY MD

Ivey Karen Belinda Divya Narayanaswamy, MD.

JACOBS LEAH OLUROPO AYENI MD

JAMES TARA JILL POTTINGER MD

JAMES TIFFANY KIMBERLY BROWN-GULLATT

JARRETT JARED LEWIS MUFID OTHMAN MD

Jason Glory Mathews Murtaza Cassoobhoy, MD

Jenkins Ctherine Alysia Mark A. Anders, MD.

JENKINS DANA CARMEL JOSEPH MD

JIVIDEN ELAINE BETH HASAN RAHMAN MD

Jobe Susan Leanne Divya Narayanaswamy, MD.

JOHNSON SHEKITA ALESIA FLEMING MD

Johnson Lari Eckert Lee David Jacobs, MD.

JOLLY TAMMY MICHELLE ONKAR KAUR MD

JONES TRACY MICHELLE NIZAMUDDIN KHAJA MD

JONES AMANDA TEREASA BALLAY MD

Jones Codi B. Thomas Christopher Garner, MD.

Jumper Hannah Rebeccah Peter W.Barrett, MD.

KAIRU LINET ERIK SHAW DO

Kalch Stacy Jaymal Patel

Kamara Asata Faith A.Andrew, MD.

Kang Jennifer Un-jin Uthan Vivaek, MD.

Kededa Berhanu E. Khalid J. Hayat, MD.

KEEL KIMBERLY ANTHONY NAZIONE DO

KELLY BEVERLY SHELLEY DAMON KIMES MD

Kennedy Debra David Levine, MD

KERI GIULIANO GENA VOLAS-REDD MD

Khun Jessica Nicole Micheal J. Mullberry, MD

Kim Jae Youn Peter Lee, MD

KING KATIE ANTHONY NAZIONE DO

KING JAIME DOLAPO BABALOLA MD



10

Knight Amanda Caldwell Andre Disodado Feria, MD.

Knowles Tonya J Altee S.Johnson, MD.

KONG LOKHANA VERA LAFOSSE DO

Kourehpazan Hengameh Timothy L. Shelton, MD

KUHN JESSICA NICOLE EILEEN JAVELLANA MD

KUTCHBACK STEPHANIE SHASHIKANT PATIL MD

LACK AMANDA SREEROOP SEN MD

Lackey Rachael Clark Michael Schmidt, MD.

Lagarde Nina Sheria Erin D. London, MD

LAMM MICHELLE MARIE NICOLAS CHRONOS MD

Lantaff Tracy Mureen Richard Martin Jabel

LAPLACE LORRAINE LAURA IRANDATHY RODRIGO MD

Law Latonya Deirdre Evans-Cosby

Layson Rachel Ann John Henry Lloyd, MD.

LEE CHIHOON SOWMYA BRAHMADEVI MD

Leppke Allison Marie Harenda Nirmal Fernando, MD.

LINDSEY PAMELA ROBERT GRANVILLE MD

Lingner Brandy S. Jehanger T. Pirzada, DO.

Lippert Beverly Jane Arthur Carlson Kendig

LLOYD DANA LAWRENCE POWELL MD

Lolley Karen Anthony Captain, MD

Lopez Melanie B. Rahwa Ghermay, MD.

Lynch Alexis Latrice Chuc Van Pham

Lynch Alexis Latrice Matthew Allan Wheat, MD.

Lyon Tammy R. Daniel L. Sandler, MD

Macon Margaret Duffy Angel S. Paas, MD.

MAHEK AMBER CHARLES ROSS MD

MAHOU VERA MICHAEL NWANERI MD

Malina Benedict James San Jose William Roy Grow, MD.

MALLOY AMITY JILL JONATHAN LEVY MD

MANLEY JANET ELIZABETH RICHARD ELLIOTT MD

MANSFIELD CRYSTAL AILEEN CLINTON CARTER MD

Martin Babayev Cassandra B. Donnelly, MD.

Mary Mary Allene David Stahura, DO

Maschinot Eve Marie Tasha Green, MD

Maschinot Eve Marie Ella Gillespie, MD

MASSOUD JESSICA HENRIETTA STEVEN DUROCHER MD

MATHEW PREETHY KOOTHUR STEVEN SIGMAN MD

MCALLISTER ALLIE MARK CHASTAIN MD

McClain Enika LaTara Kenneth E. Jones

MCDANIEL REBECCA KEVIN NAPIER MD



11

MCDONALD JENNIFER WARD GAYE HAYNES MD

MCDONALD JENNIFER JAY SCHECTER MD

McNeal Sandra Nicole Charles Jackson, MD

McQuitty Wanda Nell Helen Elaine Carrington, MD

Medina Johana Paola Herschel W. Smith, lll, MD

Mekonnen Mahlet Tassew Tesfaye, MD

Merritt Marcie G. Jay J. Jones

Merritt Marcie L. Justin Flynn Harrell, MD.

Merritt Marcie Jeffrey P. Davenport, MD.

Meyer Heidi Rae Alan Maloon, MD.

MILLER KIMBERLY BRIAN STANSFIELD MD

Moncrieffe Nicole Paul Allen, MD

Moon Yeo Jin Gabriel E.Onofre, MD.

moore PATRICIA ANN MICHELLE PLASTER MD

Moore Shannon Maurice Chen, MD

Moore Ayjanah Rasheeda Douglas Cooper, MD.

MORRIS-

HECKSTALL ROSEMARY MICHAEL POMPEY MD

Mwangi Rose M. Virginia J. Wight, MD

NELSON DOUNGPHON PAUL BRADLEY MD

NELSON TRICIA LEE JACQUELIN MILLER MD

Neu Lovie D. R.L.Talley Jr. MD.

Ng Isolda Franchini Roy Devonne Flood Jr. MD.

Nickleson Regina McIntosh Tasha L.Green, MD.

Nix Ashley C. Julie P. Hicks, MD.

NOBLES DIANE EMILE RISBY MD

NORRELL JAIMI CATHY HARPER-HOGAN MD

Ogby Maureen Iyamy Kingsley

Ograbisz Pamela Lee David Jacobs, MD.

Ohlson Kiana M. Maribel R. Woodward, MD.

Olawuyi Tiwalade Michelle Evans, MD.

Olgesby Julie A. Julie P. Hicks, MD.

Oliver Corinne Braender Kim Hyunmi, MD

OLURINDE KAY ISIOMA OKWUMABUS MD

O'neil Erica A. Vishal N.Patel, MD.

O'Rourke Patricia Ann Michelle Plaster, MD.

Ottimo Stephanie Michelle Irandathy Rodrigo, MD.

Otubaga Omolola Adeyinka Douglas Cooper, MD

OWUSU-YAW INZA JAMES BROWN JR

Oxley Kristi Ann Amy Kathryn Pearson, MD

Pace Kristen Eileen Mohan Krishnamachary, MD.

Palmer William Cody Timothy Meldon Longaker, MD.



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Paris Kimberly Dawn Andrew Pugliese, MD.

Park Emmie Norville Brian Stansfield, MD.

PARKS MELISSA BRIAN HARD MD

Patel Amisha Jaginda Mangru, MD.

PATRICK SELISHA SHITAL PATEL MD

Patron Tane Marie Antoine R. Trammell, MD.

PAYNE BRITTNEY NICHOLE SHANNON VAUGHN MD

Peacock Kimberly Hinson Davin G. Mitchell, MD

Pearson Wendy Caves Jon Christopher Gibbs, MD.

Peeler Jessica Marie Edgar N. Jackson, MD

Peronti Kelly Adam C. Webb, MD

PERREZ AMY ROGER SIMON MD

Perry Chance Franklin Smisson, MD

Perry Chance Frederick Smisson, Hugh Franklin, MD.

PHAM CHARMAINE QUIRMIT GERALD CHAI DO

Pingeton Robin Ann George Rafeedie, MD

Pingeton Robin George Rafeedie, MD

POE JESSICA MARLENE ZETZER SHIVERS MD

Porter Martin Cassandra B. Donnelly

Puckett Catherine Z. Kent I.Cohen, MD.

Quick Ashlee Janel Eric Friedrich, MD

Rabun Chasity David A. Schulte

Rakhmanova Rano Adedapo Odetoyinbo, MD.

Ranna Diane E. Patricia Kelly, MD.

Rathbun Debra Diane Charles Francis Cowart, MD.

Ray Jacqueline Marie Nalini Kumar Ramaiya, MD.

Ray Jacqueline Marie Thomas Zickgraf, DO.

Ray Amanda Joan O.Lfarinde, MD.

Redmond Erin M. Ahmed Elsharkawi, Md.

Reese Patricia Ireland Marcus Williams, MD

Register Wendy Brady Kevin Don Coyle, MD.

Reiss Eleanore Sharon Rosen Rabinovitz, MD.

Ridgley Holly Bryan Blake, MD

Rivera Sallie Jo Ioana Chirca,MD.

Rodriguez Jodie A. Daniel Saade, MD.

Rogers Sherri Michael Salvia, MD

ROGERS SHERRI MICHAEL SALVIA MD

Root Michelle Shital Patel, MD.

ROSS CICELY ANITA JOHNSON MD

Rumph David Randall Alan Dean Justice, MD.

Rusterucci Melissa Diane William C. Adcox, MD.



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Sahni Mallory Savannah Raghava Bhaskaran, MD.

Santee Tara Marianne Yee

Saucedo Israel Parviz Brahman, MD.

Scott Harpold Ashuk Kencharla, MD

Sears Krystal John Schuler, MD.

Seaward Susan D. David Leon Hocker, MD.

SHAND MICHELLE BRENDALEE SEKHAR SANKARAN MD

Shaw-Brown Luann M. Richard L.Elliott, MD

Shaw-Grant Pamela Joshua Samraj, MD.

Sheppard Brandi Lynn Amy Christie, MD.

Shoemaker Savannah A. Mary Ninan, MD

Shook Heather Michelle William Asbury, MD

Shook Heather Michelle William Asbury, MD

Shumate Donald Hugh Cline Thomas Jackson, MD.

Shurtleff Angela Maria Donald McCartney, MD

Simmons Rebecca Johnson Jeremy R. Anthony, MD.

SIMMS ASHLEY PRITCHETT CHRISTOPHER KNITING MD

SINGLETARY LIEGH RHODES JOE HARRIS MORGAN III MD

Skinner Serena S. Timothy N.McGlauchlin, DO.

SMITH VALERIE BRADEN STEVEN SPIVEY MD

Smith Shelby Juan Amador, MD.

Smithhart Lana Nicole Ibrahim Quinones, MD

SMITHHART LBRAHIM IBRAHIM QUINONES MD

Snead Keshana Crystal Owens, MD

Snell Gail Lawrence Andrew Smith, MD

Spoon Donald Craig David C. Harkins, DO.

Standefer Kimberly D. Bryan Cheever, MD.

Stauffer Joshua P. Jarod F. Bailey, DO.

Steelman Brittany C. Nathan D. Feibelman lll, MD

Stein Charles William Anthony Phillip Carter, MD

Stembridge Fredicia LaSandra James Walter, MD

Stephens Ceretha M. Miriam Gwathney, MD.

Stephenson Chelsea Lauren Damon Dell'Aglio, MD

Steverson Laura Melissa Charles F. Cowart, MD.

Stokes Crystal B. Mark Griffiths, MD.

Stout Billie S. Loretta D. Duggan, MD.

STRICKLAND SUMMER MCNEELY JAMES HILLEN

Suchanek Brittany Katherine Verena W. Brown, MD.

Sullens Amy Melissa Georges LaFleur

Sullivan Heidi Hasbrouck Richard John Barrett

SULLIVAN HEIDI HASBROUCK RICHARD BARRETT MD



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TATMAN HARDIE CALVERT PIYASH PATEL MD

Tatroe Stacey Dawn William Henry Stuart, MD.

TELLA ESTHER MILES JOHNSON MD

TETTEY-ENYO PHYLLIS SYLVANUS FIAKPORNOO MD

Thomas Keldreea Darshana Patel, MD.

THOMAS KELDREEA DARSHAN PATEL MD

THOMAS SONYA WILLIAM SHIVERS MD

THOMAS-FORD MARITESS SOWMYA BRAHMADEVI MD

THORSTEN CHERYL EILEEN JAVELLANA MD

Threat Jamie Lyall David Campbell, MD.

Tipton Anga-lee M. Micheal J. Mulberry, MD.

Tonner Karen Elizabeth Theodore McKinley, MD.

TOSH KAREN DAVID SQUIRES MD

Trubia-Shapiro Lisa Anne Gregory V. Miller, MD.

Tye Elizabeth Chritina Kile, MD

Tyrer Larry Earl Linda K.Hudson, MD.

Tyrer Larry Derrick W. Taylor, MD.

UBA SABO ATHENA SOTUS-NAWAR MD

Ulysse Tameeka S. George J. Kanes, MD.

Underhill Emily Russ R. Ayers, MD.

Wafer Christina Louise Kate Reker Raymond, DO.

Waite Jennifer Rajasekhar Reddy, MD.

Walsh Lisa Marie Vance Andre Raham, MD.

Warren Lauren Noel Stephen Tafor, MD

Watson Marsha Davette Amar V. Mohan, MD

Watts Micheal Kelly Christopher McCants, MD.

Watts Teresa Israel Bryson, MD.

Weekley Mitzi Lynn Denny, MD.

Weeks Jennifer C. Hugh W. Hall, MD.

Weiler Mercy David Fishman, MD.

WELLS TIFFANY EILEEN CHRISTOPHER SWARD MD

Whitten Shannon Elizabeth Donald R. Lynch, MD.

Wilkinson Tammie Zickgraf Thomas, DO

Williams Alysa Brielle Bradley G. Leshnower MD

Wilmer Kelly Taylor Christopher Inhulsen, MD.

Wood Jennifer Ann Sara Sambandham, MD.

Woodie Jo Ann Nathan Neufeld, DO

Woo-Whetstone Melissa Joan Thomas W. Jackson, MD.

Yates Ashley M. Erich R. Heinz, MD.

Yearby Felicia Michelle Lisa Ann Rudolph-Watson, MD.

YOUN LEE STEVEN DUROCHER MD



15

YOUNG COURTNEY ANNE WILLIAM WARR MD

Zhu Lina Zudong Zhang, MD.

Other Business:

1. Discussed clinical guidelines, and what would be acceptable guidelines. Dr. Callins will prepare

a draft for review at the next meeting.

2. Approved to update the checklist to include a contact person if there are questions on the

protocols submitted.

PHYSICIAN ASSISTANT COMMITTEE

Dr. Antalis presented the Physician Assistant Committee report as a motion. The Board accepted

the report by unanimous vote.


Approved applications for initial licensure with a supervising physician:

PA Supervising Physician

Ashley, Amanda Mullins, Michael

Boyer, Derek Dinatti, Louis

Downing, Allison

Espina, Carolina

Deutsch, Geoffrey

Conrad, Lesley

Hartley, Jamison Sacks, Todd

Hernandez, Andres Faloye, Abimbola

Ho, Sai Kit Schinelli, Anthony

Ledford, Claire King, Bernardine

Meffert, Colleen Janeira, Armando

Parsons, Kelby Babaliaros, Vasilis

Rodriguez, Angie Khan, Mohammed

Whitaker, Melissa Epps, William

Approved applications for initial licensure without a supervising physician

PA

Burch, Kia

Chamber, Kelli

Coburn, Sara

Couey, Christopher

Lee Samuel

Megay, Abigail

Mushtaq, Maham

Nguyen, Khang

Nieves, Jessica

Olliff, Rainey



16

Quinn, Caitlin

Raser, Erin

Sledge, Celine

Sullivan, Arthurlyn

Thompson, Meredith

Approved application for reinstatement a supervising physician:


Dickerson, Elizabeth

Approved application for reinstatement without a supervising physician:

PA

Concilo, Karen

Determined the following protocol agreements meet the provisions of OCGA 43-34-25 with

additions/changes:

APRN DELEGATING PHYSICIAN

Ahmadi, Shayan Stewart, Ken

Applegarth, Sarah Mangalat, Dev

Appling, Amanda Rolle, Garrison

Baker, Kirsten McGahan, Thomas

Binstock, Michael Decook, Charles

Bishop, Maryellen Gray, Leslie

Blakley, Daphne Omitowoju, Akinlolu

Box, Shea Williams, Roger

Bryan, Elizabeth Schulte, David

Buird, Julie Zickgraf, Thomas

Caughman, Deborah Wolf, Francis

Chen, Dawn Jackson, Edgar

Clements, Thomas Fulcher, Simeon

Coppinger, Charles Olszewski, Dana

Council, Brigitte Boachie-Adjei, Yaw

Courson, Clarence Wolff, Luther

Davis, Amber Villalon-Gomez, Jose

Davis, Latera Cannon, Brett

Dawson, Carrie Shaw, Christopher

Day, Jennifer Halligan, Kristin

Duncan, Megan Lynch, Lori

Easterlin, Wright Pilcher, James

Edwards, Brentan Chen, York

Farthing, Lynda Ott, Karen

Frisbee, Katie Bhakta, Ashish

Frysh, Catherine McKnight Baron, Aisha

Sadowski, Catherine



17

Frysh, Catherine Khatami, Mojgan

Garcia, Carlos Scales, Darrell

Gibson, Audrey Bognar, Marta

Gilley, Pamela Sarata, Jeffrey

Goodman, Amy Mercer, Jessica

Guerzon, Michael Chen, York

Gusick, Reena D'amato, Gina

Hall, Morgan Richter, Jeremy

Hammond, Dena Torres, Rolando

Hayes, Beckie Walland, Debra

Hichkad, Nandan Johnston, Kim

Holyfield, Jana Clayton, Mitzi

Howell, Dawn Gay, Mark

Hunt, Cynthia Smisson, Hugh

Jackman, Annanta Okeh, Victor

Jackson, Colette Heads, Kedron

Jazayeri, Seyed Jackson, Edgar

Jennings, Ronald Flexon, Phillip

Kinney, Gabrielle Deruyter, David

Lee, Katharine Azer, Wael

Leflore, Heneicia Patel, Suhel

Lester, Fleet Lee, Simon

Lott, Wynne Tucker, Charles

Luong, Phuong Adams, Alan

Lynn, Stephanie Harper, William

Manley, Emily Langer, Jodi

Maxwell, Mary Cottrell, Leslie

McDonald, Cynthia Almond, Megan

McDonald, Cynthia Asrael, David

Menard, Jessica Robinson, Joe

Metzger-Commisso, Diane Sutlive, William

Middlebrooks, Kassie Gay, Dustin

Miller, Sarah Gardner, Alan

Mills, Mark Moore, Linda

Moey, Wilmarie Crane, Sean

Morais, Jannet McMillan-Persaud, Barbara

Morris, Kacee Parker, Julieann

Munoz, Steven Dawkins, Stephen

Musgrove, Holly Dukes, Richard

Nguyen, David Shikh, Charanjit

Okunsanya, Oluwole Sceusi, Eric

Pardue, Alison Jackson, Justin

Patton, Michael Thomas, Clay



18

Peck, David Bullens-Borrow, Amy E

Peck, David Woods, Gregory

Pena, John Tarokh, Saeed

Pendrick, Denis Fishman, Eric Brian

Perdue, Scott Tarvers, Richard

Phillips, Carrie Flickinger, Brent

Pickard, Robersy Graham, Jimmy

Puckett, Jennifer Mannepalli, Supriya

Reynolds, Joseph Nwabunor, David

Saby, Paul Poddar, Satish

Simmons, Thomas Bekken, Monica

Smith, Gabriella Smith, Elizabeth

Stewart, Lauren Cox, Nancy

Strickland-Tillman, Denise Carroll, Kelley

Sullivan, Richard Bullens-Borrow, Amy

Sullivan, Richard Fisher, Stephen

Thornton, Jonathan Burris, Richard

Vassiliou, Vassilakis Haack, Matthew

Wellborn, Stephanie Jenkins, Michelle

Whitener, Robert Shikh, Charanjit

Willauer, Eva Fernando, Harendra

Williams, Gregory Decamp, Daniel

Woo, Vivian Bateman, Joe

Woodford, Brett Stechison, Michael

Wright, James Bekken, Monica

Wright, James Thobhani, Salman

Approved Add/Change applications pending additional information:


Parris, Kathleen Roman, Carlos

Quesnel, Barry Zoret, George

Approved Additional Duties Request:

Eric Chihuahua PA-C—with Dr. Ronald Walpert

Pleurx Catheter Placement Plural/Peritoneal

Gastric Tube Exchange

Bone Marrow Biopsy

Percutaneous Nephrostomy Tube Exchange

Paracentesis

Port Removal

Joint Injections - Shoulder, Hip, Writst, Knee

Thoracentesis

Picc Line



19

Michelle Forrester PA-C—with Dr. Rodney Dourron

IUD Insertion and removal

Endometrial Biopsy

Ashley Fullerton PA-C—with Dr. Michael Bosley

Lumbar Puncture

Ashley Gaulin PA-C—with Dr. Brandon Bushnell

Intraarticular Knee Injections

Subaceomial Shoulder Injections

Trachanteric Hip Injections

Stephanie Hawkins PA-C—with Dr. Deborah Baumgarten

Image Guided Paracentesis

Image Guided Biopsy

Melissa Jones PA-C—with Dr. Peter Bolan

Endoscopic Vein Harvesting

Chest Tube Removal

Whitney Knowlton PA-C—with Dr. Frederick Flynt

Bone Marrow Biopsy

Annsley Mathews PA-C—with Dr. Jeffrey Silveira

Electrocochleography

Videonystagmography

Ultrasound of Head and Neck

CT Scan of Sinus and Temporal Bone (order and interpret only)

Percutaneous and Intracutaneous Allergy Skin Tests

Nathan Potter PA-C—with Dr. Craig Patterson

Intubations

Victoria Suttles PA-C—with Dr. Jeffrey Silveira

Electrocochleography

Videonystagmography

Ultrasound of Head and Neck

CT Scan of Sinus and Temporal Bone (order and interpret only)

Percutaneous and Intracutaneous Allergy Skin Tests

Other Business:

1. TM – Invite for interview.



20

2. SF – Refer to Wellness

3. Williams, Norris - Denied application for reinstatement without a supervising physician:

COSMETIC LASER PRACTITIONER COMMITTEE

Dr. Gross presented the Cosmetic Laser Practitioner Committee report as a motion. The Board

accepted the report by unanimous vote.


Applications Approved Cosmetic Assistant Laser License:

Amber Jackson

Ashlie Phillips

Eva Taub

Jeffrey Dunn

Jennifer Addy

Kathryn Jones

Laura Perry

Meagan Thomas

Nyeema Butler

Rochelle Brown.

Sonie Clayton

Tamatha Sweet

Vinnette Wilson

Wanda Garrish

Approved Applications for Senior Cosmetic Laser License:

Sonie Clayton

Vinnette Wilson

Tabled applications for additional information:

Haley Mashburn Invalid Certificates

Cassie Craig Recommendation to wellness

Virginia Keating Invalid Certificates

Donna Stiles unable to license Missing GA Esthetician License

Other Business:

1. L.P. - Will retain previous license number practicing on Lapsed License from March to April

2. Donna Kaufman - Approved Committee recommendation for Donna Kaufman Consult with

Supervising Physician to provide 5-hour Training session for Certificates

3. Approved Committee recommendations for accepting certificates with physician signatures, the

applicant must follow the Law and Rules of the Board to only accept certificates signed by



21

physicians. The verbiage concerning the certificates needs to reflect change on the website and

the application January 1st

4. Discussed the Board teaching Laser courses.

ORTHOTIST & PROSTHETIST COMMITTEE

Mr. Wallace presented the Orthotist & Prosthetist Committee report as a motion. The Board


The Board took the following actions

Applications for Review:

Orthotist

Jaccalyn Billeter

Cecil Teague – pending additional information.

Dual License

Benjamin Tigner – pending additional information.

Rule Change:

The Board asked the staff to provide with a list of all licensed people to notify applicants that

their licenses Prosthetist Advisory Committee.

Reinstatement Application Review:

Reviewed and approved proposed changes to the Reinstatement Application.

ACUPUNCTURIST COMMITTEE

Dr. Mohan presented the Acupuncturist Committee report to the Board as a motion. The Board



Approved the following applications for initial licensure:

Lianyang He

Lee Sawyer

Approved Quarterly Reports:

Rachel Wilson

Gina Michaels

Approved Applications:

Bryan Hornburg “Limited License with supervision

Other Business:



22

1. Brian Hornburg – Refer to Supervision Rules and Laws.

2. The Committee thanked member Jenny Kearns for her services to the Board.

PERFUSION COMMITTEE

Dr. Retterbush presented the Perfusionist Committee report. The Board accepted the report by

unanimous vote.


Approve the following applicant for Initial Licensure:

Kevin Troike

Approved Application for Provisional Upgrade:

Meredith Crumpler

Other Business:

1. Please provide clarification.

O.C.G.A. 43-34-175 provides for provisional licensure for graduates of approved

perfusion programs. A provisional license is valid for two years from the date is it issued

and may not be renewed.

PAIN MANAGEMENT CLINIC COMMITTEE

Dr. Downey presented the Pain Management Clinic Committee report as a motion. The motion

was seconded by Mr. Wallace. The Board accepted the report by unanimous vote.


Approved Reinstatement:

License # Pain Clinic Name

180 Atlanta Pain Clinic

Approved Applications:

License # Pain Clinic Name

431 Ancora Pain Recovery

Add Practicing Physician William Hammonds

152 Athens Spine Center, P.C.

Add Physician Assistant Katrina Head

256 Center for Spine Interventions

Add APRN Jennifer Okeh

Add APRN Jessica Lindley

257 Center for Spine Interventions



23

Add APRN Jennifer Okeh

Add APRN Jessica Lindley

Add APRN Wilhemina Boadi-Ihenyeen

224 Harbin Clinic, LLC

Add Physician Assistant Mollie Helmerich

149, 374, 437, 439 Hemlock Pain Center

Add APRN Lauren Warren

379 Sugarhill Medical and Spine Center

Add Practicing Physician Ibrahim Opaleye

266 TDI Pain

Add APRN Kimberly Peacock

Delete Physician Assistant Gregory Butler

Delete APRN Nicole Knight

368, 369 Axis Pain Center

Add APRN Casey Clark

433 Harbin Clinic

Add APRN Latoya Simon

Dr. Retterbush motioned to go into closed session. Dr. Weil seconded the motion and it carried

unanimously.

Dr. DeLoach declared open session.

WELLNESS COMMITTEE

Dr. Collins presented the Wellness Committee report. The Board accepted the report by

unanimous vote.


1. PHP report by Dr. Paul Early and Robin McCown

2. 20121646 – Approved request to terminate Private Consent Order.

3. 20141598 – Tabled for additional information.

INVESTIGATIVE COMMITTEE

The Investigative Committee report was presented as a motion by Dr. Mohan, The Board

accepted the report by unanimous vote. The Board took the following actions.

Close:

20160513 20162133 20162326 20170337 20170449 20170951

20171140 20171141 20171251 20171326 20171363 20171370



24

20171408 20171451 20171756 20171789 20171803 20171879

20171886 20171995 20172051 20172094 20172161 20172169

20172215 20172236 20172268 20172269 20172272 20172286

20172288 20172328 20172363 20172366 20172367 20172369

20172380 20172382 20180005 20180009 20180013 20180017

20180019 20180028 20180049 20180065 20180081 20180082

20180090 20180122 20180123 20180181 20180187 20180210

20180395 20180522 20180523 20180570

Close with Letter of Concern:

20151173 20160437 20171818 20172181 20172266 20172355

20172360 20172373 20180037 20180467

Invite for Investigative Interview:

20130270 20141729 20150843 20170116 20170434 20172351

20172371 20180136

Further Investigation

20171702

Table

20170011 20171106

Attorney General’s Office

20171423 20180179 20180180 20180467 20180704

Peer Review

NONE

OMPE

NONE

INITIAL COMPLAINT EVALUATIONS

The Board approved the following recommendations.

20170976 20180042 20180557 20180577 20180579 20180590

20180596 20180598 20180601 20180604 20180615 20180616

20180618 20180620 20180624 20180629 20180638 20180640

20180642 20180647 20180648 20180661 20180668 20180670

20180682 20180694 20180698 20180710 20180717 20180722



25

20180725 20180727 20180728 20180730 20180731 20180733

20180734 20180735 20180742 20180743 20180745 20180746

20180748 20180749 20180751 20180756 20180757 20180761

20180764 20180766 20180767 20180769 20180770 20180771

20180772 20180773 20180775

RECUSALS

Antalis 20180733

Callins 20170633

DeLoach 20171408 20171702 20172380 20172382 20180733

Harbin Jr. 20180523 20180590

Marshall 20172355 20180082 20161239

Retterbush 20170951 20180123 20180733

Weil 20162326 20171408 20172094

LEGAL ENFORCEMENT ACTION REPORT (LEAR)

Mr. Reimers presented the LEAR. . Dr. Retterbush submitted a motion, seconded by Mr.

Wallace, to accept the report. The motion carried unanimously.

1. Tara Tillman Salley, Asst. Laser Practitioner - Accept Inactive Status.

2. 20161632 - Upheld Board Decision.

3. 20130851 - Approved request to release files.

4. 20162232 - Approved request to release files.

5. 20161239 - Upheld Board Decision.

6. 20121132 - 90 days to adhere to Florida CARES.

7. Robert Dewitt Jones, MD - Accept Inactive Status request.

INVESTIGATIVE INTERVIEW REPORT

Dr. Retterbush, M.D. presented the Investigative Interview report as a motion. The Board


The Board took the following actions.

20160171 Accept Inactive 20161584 LOC

20170524 LOC 20170633 LOC

20170862 Table 20171622 Table

20171671 LOC 20171768 Close

20171893 Close 20171957 Close



26

RESPIRATORY CARE COMMITTEE Dr. Collins presented the Respiratory Care Committee report as a motion. The Board accepted

the report by unanimous vote.


Approved Reinstatement applications:

Bruce, Jeremy

Flagge, Corey

Mamatz, Astrid

Powell, Clayton

Stone, Ryan

Approved Reciprocity Applications:

Aubrey, Julie

Bivins, LaQuandra

Bussell, Amy

Campbell, Kenecia M

Franklin, Shiela Robinson

Gillette, Beth

Gomez, Ricardo

Johnson, Chelsea

Louckes, Ashley Wilson

Pei, Contien

Pinson, Jerica

Poremski, Megan

Rodriguez, Maacah

Samura, Emmanuella

Santiago, Jessica

Smith, Vivian

Approved 12- Month temporary permit:

INDEPENDENCE:

Daniel, Georgene

ALBANY STATE:

Bentham, Becky Lee

Butler, Tequilla M.

Cain, Kristen

Davis, Afika

Durden, Sherrell



27

Faircloth, Candiss A

Gilbert, Shanquisha L.

Harris, Danielle M.

Martin, Elizabeth, B

Sanders, Heather Elizabeth

Williams, J. L.

COASTAL PINES: pending additional information.

Brown, Kenya

Cook, Trent C

Dillard, Brittany

Jowers, Erica L

Mizell, Kourtney

Spurlock, Madison

Woods, Heather

SOUTHERN CRESCENT – pending additional information.

Edwards, Mary Ann

Foster, Akilah

Fowler, Olivia

Gunn, Temitrus

Heflin, Antoinette

Jordan, Courtney

Knauls, Leslie

Maddox, Rachel

Martin, Carla

Pryor, Kayla

Salami, Cynthia

Santiago, Eliva

Siriani, Kristin

Tucker, Christian

Walker Nicolea Monquell

Warmack, Jonathan

Bonny, Marie V

Other Business:

1. Tabled CEU rule.

2. Tabled scope of practice questions for further research.

3. Reviewed proposed changes to reference Forms B and B11. Board did not amend the

forms.

4. Reviewed response from the Governor’s office to the research question “requirements for

oxygen concentrators in Georgia”. Tabled to January board meeting for further review.



28

Administratively Approved up-grades

Achionye, Nkiruka

Barajas, Liliana

Bonner, Whitney

Bossie, Joseph Anderson

Brown, Angela

Clay, Midale I

Cornejo-Bedolla, Dibisais

Ellington, Joseph Aaron

Fears, Kailah

Goodwill, Alyssa

Joyner, Lindsey

Lyles, Jasmine Wadesha

Mukendi, Cynthia

Osei Basah, Alice

Patel, Miksu

Rush, Arroya Cheikeen

Speer, Leslie Lynn

Trotter, Shavakia

LICENSURE COMMITTEE

Dr. Retterbush presented the Licensure Committee report as a motion. The Board accepted the

report by unanimous vote.


Other Business

1. Petitions to Waive Rules

a. Siska-Castro,

Cesar

Approved 360-0.02

b. Berlin, Agnes Table for USMLE Score

Transcript

360-2-.03(5)

c. Schrepfer, Thomas Approved 360-2-.02 (5)

2. Tuttle, Jessica Requesting a copy of application. Approved

3. 2018 Learning

Summit (CPEP)

Presented as Information Only Accepted as Information Only

4. Manikal, Vivek Requesting copy of medical school

certification to be sent to AL State

Board.

Approved

5. Hercule, Hanz Requesting a copy of application

file.

Approved



29

6. Eisen, Hugh Requesting renewal w/o

reinstating.

Complete Reinstatement Application

7. Glass, Roger Requesting renewal w/o

reinstating.

Complete Reinstatement Application

8. Board Staff PR verifications secondary to

Hurricane Irma.

Allow up to 6-month period to start

12/7/17 to accept copies of PR

verifications.

9. Klausner, Robert Requesting to renew with lower

fee amount.

Complete late renewal before expiration

of license.

10. AG Consent Order

Referral Form

Submitted for review/approval Accept form as submitted but include

Other Comments

11. Pierzchala, Julia Clarification regarding attempts to

take COMLEX exam.

Deny based on non-sponsorship of

examination retakes by Georgia

Composite Medical Board

Initial/Reinstatement Applications Approved:

Kasirajan, Karthikeshwar

Ayinde, Hakeem

Alqulali, Mona

Park, Robert

Wyatt, Felecie

Sinada, Musadaq

Shekiladze, Nikoloz

Miller, Angela

Farooqui, Falahat

Stewart, Charles

Critides, Samuel

Groover, Tiffany

Soika, Christopher

Patel, Chetan

Maslin, Peter

Dascal, David

Duvall, Penelope

Sado, Anthony

Jones, Djuna

Connolly, John

Clark, Kudiratu

Roesch, Thomas RNST

Applications Not Approved

AT Clinical Skills Examination or Administrative License

CSC Deny or allow to withdraw because training inconsistencies and

quality and issues with license applications.

PT Deny or allow to withdraw, or complete Clinical Skills Examination



30

BUO Interview regarding training and current practice plans

MF Interview re malpractice history

License/Reinstate with Consent Order

VE Approved license

AC License with terms and conditions.

License Pending Information

RC Table

LE Table

Previous Decisions Upheld

Tariq, Ambreen Uphold previous decision to Deny

Bowles, Theodore RNST Uphold previous decision to Deny

Consent Order for Board Approval

Cooper, Carl J. RNST

Approved the following applications for initial physician licensure by administrative action

79267 DEBROSSE, MAXIME MD

79270 LI, XIAN MD

79271 MCCAW, KRISTINA JHEANELLE MD

79272 MCDERMOTT, ANDREW JOHN MD

79273 PECKSKAMP, LINDSAY JO DO

79274 MAIMON, HADAS MD

79275 NOVIKOV, MIKHAIL MD

79276 LEE, HEE-CHOON SAMUEL MD

79277 MUHAMED, SHEHZAD MD

79279 MANGAT, NAVDEEP MD

79280 MAXWELL, CHARLES ISAAC DO

79281 MORENO, YVONNE CESENA MD

79282 NADOLSKY, SPENCER DO

79283 NSUNWARA, AFFIONG AMBA MD

79284 PONCE ALVAREZ, MARIO CARLOS MD

79285 MCCLAIN, JUSTIN WILSON MD

79286 NADIG, NISCHAL SUERSH DO

79288 GOBER, JAIME MARIE MD

79289 NAGARAJA, HARSHA GHATGE MD

79290 OCONNELL, TRACEY MD

79291 PATEL, RUBIN MD

79292 GOPIN, JOAN MARY MD

79293 NAYYAR, ANKIT MD

79294 OTTO, RICHARD S J MD

79295 MULLINS, JEFFREY KYLE MD

79297 LEBEC, DAVID RICHARD MD



31

79298 KIRKS, RUSSELL CONNELLY JR MD

79301 SEMBRANO, SVETLANA ROSE MD

79302 AGARWALA, SANJAY KUMAR MD

79303 OWENS, TIFFANY SHARAE MD

79304 MOHAN, BABU PAPPU MD

79305 LAMBA, SUMANT MD

79306 LAW, SIDNEY MD

79310 BOMBULIE, MARK MD

79311 KADIMI, SRINATH MD

79312 MAGDY, MOHAMED ABDEL MD

79315 AVILA, AMANDA JANE MD

79317 ANACIUS, ELISABETH MD

79318 RICE, MATTHEW SPRAGUE MD

79319 REEVE, THOMAS ELLIS IV MD

79320 SILBERMAN, MARK ALAN MD

79321 SALMON, ADRIAN ALBERTO MD

79322 SALVATORE, JAIME DO

79323 TIO, LEON DO

79324 VISSER, JESSICA MD

79326 VOVAN, HOUSTON MD

79327 TAGOE, UDELE JOYCE MD

79329 WALVICK, MATTHEW DAVID DO

79330 HOWARD-ANDERSON, JESSICA RENEE DR MD

79331 YOUNGGREN, BRADLEY N MD

79332 ZAND, RAMIN DO

79333 KEEGAN, CATHERINE NGUYEN MD

79334 TAYLOR, DEBORAH JO MD

79335 SIKORA, LINDSAY MD

79337 ALLURI, ABHISHEK VARMA MD

79338 BALASURIYA, RAJINDER DAYAN DO

79339 BIJWADIA, JAGDEEP SUBODH MD

79340 JOHNSON, WILLIAM BRADFORD MD

79341 ESPINOZA, FABIOLA MD

79342 GUTTMAN, JOSHUA MD

79343 KHURANA, ANJALI MD

79344 ELAM, APRIL DANITZA MD

79346 GOODRUM, ALISHA RENAE MD

79348 GRADY, ERIN MD

79349 GONZALEZ, ADRIANA MD

79350 GORDON, SCOTT MD

79351 STACK, RICHARD S MD

79352 STEFFENS, ROBERT MARK MD

79353 SCHNEIDER, NEIL FREDERICK MD

79354 DECASTRO, IGOR MD

79355 READE, ERIN PARRISH MD



32

79356 BEAU, JULLIAN STANLEY MD

79357 NICKELEIT, VOLKER MD

79358 ATTAWAY, DAVID SPENCER MD

79359 ABSALOM, NICHOLAS MICHAEL MD

79360 MAY, JASON R MD

79361 PERRY, ISAAC EZRA DO

79362 PAKANATI, ABHINANDAN REDDY MD

79363 MALLAVARAPU, CHRISTOPHER THOMAS MD

79364 MARTIN, ALEXANDRA MD

79365 PUOPOLO, ANTHONY DAVID II MD

79366 MIYAZAKI, KAORU MD

79367 MURPHY, BRYANT ARMOND MD

79368 PIOTROWSKI, MELISSA MD

79369 NGUYEN, DAVID THAI MD

79370 MOWZOON, NIMA MD

79371 MEHRA, VIKRAM MD

79372 MOUSSOUTTAS, MICHAEL MAKRIDES MD

79373 HARDEN, BAHATI MD

79374 FRIDDELL, ROY ANTHONY MD

79375 CUEVAS, CHRISTOPHER CUEVAS MD

79376 AWOLESI, MARK AKINTUNDE MD

79377 HOLUBEK, WILLIAM JOHN MD

79378 ADDO, REGINA CAROL MD

79379 ARUKALA, KEDAREESHWAR SANJAY MD

79380 AHMED, AMIR RASHEED MD

79383 GOSS, JONATHAN MD

79384 WALLER, JOSEPH GABEL MD

79385 JAIN, JUHI MD

79386 AMARAPURKAR, POOJA DEEPAK MD

79387 BADRINATHAN, BARATH RAM MD

79388 BASU, RESHMI MD

79389 BRAR, SONIA MD

79390 ROSENTHAL, JENNIFER ILENE MD

79391 RAWLINGS, JOHN MURDOCK MD

79392 JAMES, JEFFREY NELSON MD

79393 RAZA, ALI MD

79394 ROWLETT, WILLIAM TAYLOR MD

79395 SHERIDAN, MICHAEL JAY SCOTT MD

79396 SHAH, SUNIL MD

79397 WESLEY, PAUL DO

79398 WHITAKER, MALCOLM ARTHUR MD

79399 WEISSMAN, DAVID ERIC MD

79401 WEINER, PAUL MILTON MD

79402 JAGGI, PREETI MD

79403 USMANI, NADEEM MD



33

79405 RAVI, FNU MD

79406 HODGES, LEROY WARREN MD MD

79407 CHAN, GILBERT MD

79408 WATSON, BRIAN WESLEY MD

79409 COLE, SHANE MD

79411 DAVIS, CRAIG MICHAEL MD

79412 DHALA, ATIYA MD

79413 SHAH, TINA MD

79414 GRAVELEY, MICHAEL MD

79415 HO, JONATHAN NGOC MD

79416 GOODEN, GAY MARIE MD

79417 TAHA, AMMAR MD

79418 PIERRILUS, JEDLYN MD

79419 GAZZALA, JAWAHAR REDDY MD

79420 KUNTER, GHADA MAHMOOD MD

79421 ONTELL, JAMES DO

79422 MARTELL, MATTHEW HARRISON DO

79423 PASTERNACK, JENNIFER MARTINE MD

79424 OLTERMANN, MARK H MD

79425 PIERCE, DEIDRE MURRY MD

79426 LI, LIN MD

79427 LOPEZ, GUSTAVO A MD

79428 MCDERMOTT, DANIEL DO

79429 PORTER, JAYCE BENSON DO

79430 OYENUGA, OYELADUN MD

79431 MIAN, MATTHEW MD

79433 ORTIZ, JACOB R MD

79434 MAJ, LUKASZ MD

79435 MAHONEY, JOHN RYAN DO

79436 LANGERMAN, FAWN MICHELLE MD

79437 PRESS, OSCIRIAH SOSTAN MD

79438 MILLER-HAMMOND, KIMBERLY E MD

79439 DUNCAN, SIBYL MONIQUE MD

79440 DORZIN, ESTHER MD

79441 BEDNOV, EUGENE VITALY MD

79442 CHAMPION, DEANN K MD

79443 ASAGWARA, ROMMEL IJEOMA MD

79444 DUNLAP, STEPHANIE HOPE DO

79445 HUTCHINGS, JEFFREY CHARLES MD

79447 JEAN-CHARLES, DAROINE MD

79448 FOSTER, APRIL DO

79449 GOLDEN, BRADLEY MICHAEL DO

79450 ANEWENAH, LESLIE STANISLAUS MD

79451 BLOOMER, ZACHARY W MD

79452 JENKINS, OLIVER H MD



34

79453 GENDEH, MANVIN KAUR MD

79454 NEW, PAMELA ZYMAN MD

79455 CONNOLLY, JOHN W MD

79457 PARK, KYUNG SUN MD

79458 SHEKILADZE, NIKOLOZ MD

79459 PATEL, CHETAN RAMAN MD

79460 MILLER, ANGELA ROSE DO

79461 PETER, MASLIN IVAN DO

79462 STEWART, CHARLES RAY MD

79463 SOIKA, CHRISTOPHER WILLIAM MD

79464 AYINDE, HAKEEM MD

79465 SADO, ANTHONY S MD

79466 SINADA, MUSADAG MAMOUN MD

79467 BOWERS, KAREN JEAN MD

79468 CRITIDES, SAMUEL DEMETRIOS JR MD

79469 DASCAL, DAVID ELLIOT MD

79470 DUVALL, PENELOPE CHURCHILL MD

79471 ALQULALI, MONA MD

79472 EL HAWARI, MOHAMAD KASSEM MD

79473 FAROOQUI, FALAHAT MD

79474 GROOVER, TIFFANY MD

79475 EVANS, VANNESSA DENISE MD

79476 THUMMALURU, JAHNAVI MD

79477 VICKERY, BRIAN PATRICK MD

79478 TAHIR, ASIF NADEEM MD

79479 RAGAZINO, JAMES ERIC MD

79480 VISSER, JEFFREY DAVID MD

79481 SHERROW, LEIGHANNE KATHERINE DO

79482 VEDROS, JARED DO

79483 SMITH, DAVID EARLE MD

79484 STEPHENSON, LENZY CAROLINE DO

79485 CHERMAK, RICHARD BARRY MD

79486 EINSTEIN MORROW, GABRIELLE FAITH MD

79487 RAMADHAS, ANUSHA MD

79488 RIFF, JOSHUA JONATHAN MD

79489 TEDJA, MARILYNN MD

79490 VIDGOP, YELENA MD

79491 ALLAEI, ATABAK MD

79492 SEYWERD, KATERINE ADELHEID MD

79493 KATHURIA, KANIK MD

79494 FANCHER, GAIL DENISE DO

79496 JOVANOVICH, ALEXANDAR MD

79497 MCCASKILL, RODNEY LEE MD

79498 KHAN, MUHAMMAD AZEEM MD



35

CLOSED SESSION

Dr. Marshall ubmitted a motion, seconded by Dr. Retterbush, to go into executive session to

discuss investigative matters. Upon conclusion of the Board’s discussion of the matters, Dr.

DeLoach declared the meeting in open session.

Dr. Robinson submitted a motion, seconded by Dr. Callins, to accept the report. The motion

passed unanimously.

There being no other business, Dr. Marshall submitted a motion, seconded by Dr. Callins, to

adjourn the meeting. The motion carried unanimously. Dr. DeLoach adjourned the December 7,

2017 meeting at 4:30 PM

__________________________________ _____________________________________

E. Daniel DeLoach, MD LaSharn Hughes, MBA

Chairperson Interim Executive Director

__________________________

Recorded by Diane Atkinson

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