Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
1
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.
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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.
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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.
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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
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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
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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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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.
The Board took the following actions:
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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Quinn, Caitlin
Raser, Erin
Sledge, Celine
Sullivan, Arthurlyn
Thompson, Meredith
Approved application for reinstatement a supervising physician:
PA 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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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:
PA Supervising Physician
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
Georgia Composite Medical Board
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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.
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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.
The Board took the following actions:
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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
accepted the report by unanimous vote.
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
accepted the report by unanimous vote.
The Board took the following actions:
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:
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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.
The Board took the following actions:
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.
The Board took the following actions:
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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.
The Board took the following actions:
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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
accepted the report by unanimous vote.
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
26
RESPIRATORY CARE COMMITTEE Dr. Collins presented the Respiratory Care Committee report as a motion. The Board accepted
the report by unanimous vote.
The Board took the following actions:
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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.
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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.
The Board took the following actions:
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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
Georgia Composite Medical Board
Minutes of the December 7, 2017 Meeting
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