ALASKA STATE MEDICAL BOARD SUMMARY OF BOARD

11/1/2018 Iutzi, Brian J. MD 2018-000178 123513 Board order modifying 2/1/18 consent

agreement

Removed psychotherapy counseling requirement All other conditions remain, incl. 2-yr probation, support group, random

testing, reports to board, other conditions

11/1/2018 Stillner, Verner MD 2018-000222 MEDS4023 Consent Agreement with reprimand

and fine of $1,000

Failure to comply with CME requirements in audit of

license renewal

Compete addl CME; mandatory audit for next 2 licensing periods

10/31/2018 Ditzler, John R. MICP 2013-001477 MEDM390 Release from Confidential

Nondisciplinary Consent Agreement

Satisfied terms of agreement None

9/30/2018 Osterbauer, Peter J. MD 2018-000793 MEDS6271 Decision and order following hearing Board adopted revised decision replaced summary

suspension with 2-year suspension, reprimand, fine

due

Cannot practice in Alaska; must comply w/ consent agt, complete

rehab program, document 2 yrs continuous sobriety before applying to

reinstate under new consent agt.

8/6/2018 Wasile, Olga Iris MD 2014-001410 MEDS4987 Termination of Probation Satisfied conditions of her 2015 Consent Agt.

8/28/2018 Osterbauer, Peter J. MD 2018-000793 MEDS6271 Accusation filed

8/24/2018 Nasky, Kevin Michael DO n/a n/a Application withdrawn Application withdrawn for unspecified reasons No license issued

8/16/2018 Osterbauer, Peter J. MD 2018-000793 MEDS6271 Suspension of License License suspended for failing to comply with a Board

order, violating the conditions of his 5/4/17 consent

agreement

Cannot practice in Alaska.

8/3/2018 Schurig, Samuel H. DO 2018-000391 MEDO1967 License surrender Under investigation concerning violations of

professional standards, prescriptive practice, and

unproffessional conduct.

Cannot practice in Alaska

8/3/2018 Pakzad, Zima MD 2017-000797 Nondisciplinary consent agreement,

Imposition of Civil Fine of $1,000

Rescind 5/3/18 license denial; civil fine for failure to

disclose material information in appl for license in AK;

license application to be processed

Cannot practice in Alaska until application is processed and license is

issued.

8/2/2018 Ghosh, Shubhranjan MD 2014-000786,

2016-000343

MEDS6297 Revocation of license Revocation by default; false/misleading advertising,

false/misleading testimony or statements, after

license suspended for felony conviciton of Medicaid

Fraud, crime involving unlawful procurement, sale,

prescription or dispensing of drugs.


8/2/2018 Lietzke, Christiana MD 2016-000690 MEDS8212 Suspension of License Based on revoked, suspended licenses in MT, AL,

NC, WA, CA, UT


8/2/2018 Schwartz, James R. MD 2017-000729 MEDS8086 Consent Agreement with reprimand

and fine of $1,000


license renewal


6/12/2018 Chadek, Richard Frank MD n/a n/a Application withdrawn Application withdrawn for unspecified reasons No license issued

6/12/2018 Kozlova, Olga G. MD 2017-001193 n/a Application withdrawn Application withdrawn while under investigation for

discrepancy in information provided during application

process.

No license issued

5/25/2018 Mills, Barry Joseph MD n/a n/a Application withdrawn Application withdrawn for unspecified reasons No license issued

5/25/2018 Cordero, Pedro Evelio MD 2018-000256 n/a Application withdrawn Application withdrawn while under investigation for


process.

No license issued

ALASKA STATE MEDICAL BOARD

SUMMARY OF BOARD ACTIONS - 1997 to present

PLEASE READ: This report is a summary of actions taken by the medical board, and includes a brief reason for the action. It is NOT intended to be a complete and thorough explanation for the boards decision or action, nor is it intended

as a presentation of the merits of actions. For copies of complete actions, contact the boards office.

LIC NO. TYPE OF ACTION REASON FOR ACTION RESTRICTIONS/CONDITIONS ON LICENSE

DATE OF

ACTION NAME PROF CASE NO.

Report revised: 11/19/2018 Page 1 of 45






DATE OF


5/4/2018 Lindeke-Renfer, Melia Lane MICP 2017-000051 MEDM796 License suspension lifted Satisfied terms of 1-yr suspension; Consent

Agreement w/ probation, reprimand, fine of $2,500

(suspended), continues to 5/4/23

Suspension lifted - remaining terms of consent agreement in place to

5/4/23, incl. 5 years probation, rehab counseling, reports to the Board,

no alcohol/drug use, impaired provider program, random testing,

restriction on remote employment, limit acces to controlled substances,

supervised employment

5/3/2018 Jensen, Christopher J. MD 2017-000131

and 000878

MEDS6676 Denial of request to reinstate

suspended license

Board is unwilling to consider reinstatement until he is

able to demonstrate at least two years of

documented sobriety, complete a Board-approved

rehabilitation program, and complete a Board-

approved physician re-training program.

Not authorized to practice, license suspended 2/7/18

5/3/2018 Rimpel-Andre, Robert MD 2018-000219 MEDS3667 License surrender Failure to comply with CME requirements in audit of

license renewal


5/3/2018 Robertson, Michael DO 2017-001121 MEDO4338 License surrender Under investigation concerning violations of

professional standards, prescriptive practice and

substance abuse, and surrender of DEA registr.


5/3/2018 Pakzad, Zima MD 2017-000797 License Application Denied Denied based on unprofessional conduct when failing

to disclose material information on a license

applicaiton and failing to cooperate with an official

investigation.


2/12/2018 Patton, Paul Lin PA-C 2014-001485 PADA1214 Release from 2/5/15 Confidential


Satisfied terms of agreement None

2/9/2018 Odom, David MD 2800-09-0122;

OAH 12-0111-

MED

MEDS1288 Reversal of license revocation AK Supreme Court order for reversal of the 6/5/14

and 9/7/15 license revocation

None

2/7/2018 Jensen, Christopher J. MD 2017-000131

and 000878

MEDS6676 Suspension of License License suspended for violating the conditions of his

11/2/17 consent agreement


2/1/2018 Hutsinpiller, Molly MD 2016-000470 MEDS4246 Termination of Probation Satisfied terms and released from Utah probation

probation agreement; released from probation

imposed under 8/4/16 consent agreement

None

2/1/2018 Iutzi, Brian J. MD 2017-000878 123516 Consent Agreement with 2 yrs

probation/monitoring

Previous impairment issues and license

action/restrictions by other state Boards

Two-yr probation, requirement for counseling/ therapy, support group,

random testing, reports to board

2/1/2018 Jensen, Christopher J. MD 2017-000878 MEDS6676 Imposition of Civil Fine of $1,000 Failure to report other state licensing sanction within

required timeframe

2/1/2018 Smith, Donald E. PA-C 2017-001180 PADA340 Imposition of Civil Fine of $1,000 Failure to file collaborative plan within required

timeframe

2/1/2018 Steele, Ralph E. MD 2017-001004 124097 Imposition of Civil Fine of $1,000 Failure to disclose required information on new

license application

1/8/2018 Filsoof, David Mansouer MD n/a n/a Application withdrawn Application withdrawn due to change of plans No license issued

1/8/2018 Baxt, Brian David MD n/a n/a Application withdrawn Application withdrawn due to change of plans No license issued

12/14/2017 Myers, Larry R. MD 2017-000426,

2017-000839

MEDS6657 License surrender Under investigation for other state license license

action


12/14/2017 Delashaw, Johnny B. Jr. MD 2017-000992 105106 Suspension of License Under investigation for other state license license

action


11/2/2017 Spencer, Roger W. MD 2014-002023 &

2015-000287

MEDS8246 License surrender No longer practicing in Aalska

--


Page 2 of 45






DATE OF


11/2/2017 Grube, Lorraine PA-C 2017-000744 115540 Consent Agreement w/ reprimand,

license supsension, fine of $2,000

Misrepresenting or conceling information regarding

past license action to obtain a new/renewed license

and to apply for a medical job

30 day license suspension, ethics course, fine, and reprimand.

11/2/2017 Mickleson, Dennis Lynn MD 2010-000816 MEDS2638 License surrender No longer wishes to abide by terms of 11/4/09

consent agreement; no longer practicing in Alaska


11/2/2017 Jensen, Christopher J. MD 2017-000131 MEDS6676 Consent Agreement w/ license

supsension, 5 yr probation, fine of

$3,000

Lifted 3/3/17 suspension subject to terms of consent

agreement; license was summarily suspended due

to impariment and mental health issues posing a

clear and immediate danger to public health and

safety

9-mo. license suspension, 5 yr probation, psychotherapy counseling,

reports to the Board, no alcohol/drug use, impaired provider program,

random testing, sleep study eval, restriction on remote employment,

11/2/2017 Dingeman, Robert MD 2017-000727 MEDS2137 License surrender Failure to comply with CME requirements in audit of

license renewal


11/2/2017 Boyer, Steve Clair MD 2017-000866 MEDS3936 Consent Agreement with reprimand

and fine of $1,000


license renewal


11/2/2017 Adler, Richard S. MD 2017-000728 MEDS7707 Consent Agreement with reprimand

and fine of $3,500 (w/ $2,500

suspended)


license renewal


10/25/2017 Schurig, Samuel H. MD 2802-07-005 MEDO1967 Termination of Probation Satisfied terms of probation imposed under

10/25/2007 MOA

None

8/3/2017 Oliver, Kelton MD 2014-001768 MEDS5313 Decision and order following hearing Board adopted proposed decision for 3-year

probation, reprimand, fine of 7,500 (w/ 5,000

suspended) due to conviction of crime involving moral

turpitude

3 yr probation w/ no crimes of moral turpitude

8/3/2017 Kindell, Gary Ray MD 2012-000957 MEDS6365 Release from 7/26/12 Consent

Agreement

Board accepted monitoring and CME completed

under OK order as meeting terms of the agreement

None

8/3/2017 Ghosh, Shubhranjan MD 2014-000786 MEDS6297 Denial of request to reinstate

suspended license

Denial based on felony conviciton of Medicaid Fraud,

crime involving unlawful procurement, sale,

prescription or dispensing of drugs.

Not authorized to practice, license suspended 9/17/15

8/3/2017 Lindeke, Melia Lane MICP 2017-000051 MEDM796 Consent Agreement w/ license

suspension, probation, reprimand,

fine of $2,500 (suspended)

Impairment issues, drug diversion while practicing RN One year license suspension, 5 years probation, rehab counseling,

reports to the Board, no alcohol/drug use, impaired provider program,

random testing, restriction on remote employment, limit acces to

controlled substances, supervised employment

8/3/2017 Winingham, Donna MD 2017-000777 MEDS4838 Imposition of Civil Fine of $1000 Failure to report DUI charge within required

timeframe

8/3/2017 Bowman, David P. DO 2017-000070 113132 Imposition of Civil Fine of $1000 Failure to disclose required information on new

license application

8/3/2017 Young, Megan Marie MD 2017-000679 120879 Imposition of Civil Fine of $1000 Failure to disclose required information on new

license application

8/3/2017 Singh, Harnek MD 2017-000417 113473 Imposition of Civil Fine of $1000 Failure to disclose required information on new

license application

8/3/2017 Abram, Jill Denise MD 2017-000336 MEDS6985 Imposition of Civil Fine of $1000 Failure to report DUI charge within required

timeframe

8/3/2017 Myers, Larry Richard MD 2017-000426 MEDS6657 Consent Agreement w/ probation,

restrictions

License action in another state w/ practice restrictions Probation and conditions to mirror Oregon order, including chaperone

req. when treating female patients

8/3/2017 Pappenheim, John E. MD 2017-000473 MEDS6873 Consent Agreement with

probation/monitoring, reprimand, fine

of $4,000 (w/1,500 suspended)

Impairment issues, failure to report hospital privileges

action, practice while license was lapsed

Five-yr probation, requirement for counseling/ therapy, no alcohol/drug

use, AA, PHC, reports to the Board, random testing, restriction on

remote practice

Page 3 of 45






DATE OF


8/3/2017 Stadnick, Michael E. MD 2016-001047 MEDS6844 Consent Agreement with reprimand

and fine of $3,500 (w/ $1,500

suspended)


license renewal


7/28/2017 Blattner, Charles David MD 2017-000345 MEDM463 Reinstatement application withdrawn License reinstatement application withdrawn while

under investigation

No license issued

7/28/2017 Simmons, Willis M., Jr. MD 2017-000048 MEDS1779 Renewal application withdrawn License renewal application withdrawn while under

investigation

No license issued

7/28/2017 Wortmann, Eric William MD n/a n/a Application withdrawn Application withdrawn for unspecified reasons No license issued

7/28/2017 Sidhu, Navpreet MD n/a n/a Application withdrawn Application withdrawn due to change of plans No license issued

5/4/2017 Erickson, Wade Steven MD 2015-001493 MEDS4593 Release from terms of 2/3/17

Consent Agreement

Complied with terms of agreement None

5/4/2017 Hyatt, Gregory T. MICP 2017-000172 MEDM163 Imposition of Civil Fine of $1000 Failure to report misdemeanor conviction within

required timeframe

5/4/2017 Granger, Shawn P. MD 2017-000038 MEDS3146 Imposition of Civil Fine of $1000 Failure to report other state licensing sanction within

required timeframe

5/4/2017 Stiles, Linda E.S. MD 2017-000037 100066 Impositon of Civil Fine of $1000 Failure to report other state licensing sanction within

required timeframe

5/4/2017 Osterbauer, Peter J. MD 2014-000153,

2017-000119

MEDS6271 Order lifting suspension of license

and new Consent Agreement with

reprimand, fine of $10,000, and 10

years probation

Lifted 5/5/16 suspension subject to conditions of new

consent agreement

10 years probation with reporting and treatment provisions; random

testing; regular testing during work shifts; restrictions on remote

practice; abstinence, etc.

5/4/2017 Bubnar, Tyson PA-C 2016-001260 PADA931 Imposition of Civil Fine of $1000 Failure to report other state license action within

required timeframe

5/4/2017 Schreiber, Zvika MD 2016-0011291 115464 Impositon of Civil Fine of $1000 Failure to disclose required information on new

license application

4/11/2017 Rudersdorf, Patrick Donohue MD n/a n/a Application withdrawn Application withdrawn for unspecified reasons No license issued

4/11/2017 Patel, Akshal Sudhir MD n/a n/a Application withdrawn Application withdrawn for unspecified reasons No license issued

3/3/2017 Jensen, Christopher J. MD 2017-000131 MEDS6676 Summary Suspension License suspended due to impariment and mental

health issues posing a clear and immediate danger to

public health and safety


3/2/2017 Jensen, Christopher J. MD 2017-000131 MEDS6676 Accusation Alleged impariment and mental health issues related

to fitness to practice; failure to report hospital

privileges action to the Board

2/3/2017 Greer, Jordan H. DO 2016-000255 MEDO2266 License Surrender Under investigation for failure to comply with a Board

order


2/3/2017 Grindeland, Isaac R. MD 2016-001410 MEDS8277 Imposition of Civil Fine of $1000 Failure to disclose required information on renewal

application

2/3/2017 Erickson, Wade Steven MD 2015-001493 MEDS4593 Consent Agreement w/ reprimand,

fine of $2500, 15 day license

suspension, addl. education

Delegating medical duties to an individual who was

not licensed to perform those duties; allowing that

person to evaluate, diagnose and treat; not providing

proper supervision of patient care

License suspended for 15 days beginning 2/7/17; additional education

2/2/2017 Padilla, Nyree MD 2016-001294 113432 Imposition of Civil Fine of $1000 Failure to disclose required information on license

application

Page 4 of 45






DATE OF


2/2/2017 Khabir, Jeffrey A. MD 2014-001177 MEDS3557 License Surrender Under investigation for allegations of substance

abuse of alcohol and failure to notify the Board of a

conviction


2/2/2017 Rougeux, Richard Thomas MD 2010-000820 MEDS6178 License Surrender No longer working in Alaska; 10/17/07 MOA will be

reinstated if pursuing a new license in Alaska


2/2/2017 Worthington, Bart DO 2016-001124 111788 Imposition of Civil Fine of $1000 Failure to disclose required information on license

application

11/9/2016 Lyons, Maurice I. DO n/a n/a Application withdrawn Application withdrawn due to change of plans No license issued

11/4/2016 Albrecht, Jeffrey Michael PA-C n/a n/a License Application Denied Denial based on previous/pending investigations/

actions/limitations/restrictions by other state Boards;

previous criminal charges/convictions, previous

unprof conduct re: practice supervision/prescription

issues; and surrender of ID license while under invest


11/3/2016 Lagatutta, Francis P. MD 2016-000770 105914 Impositon of Civil Fine of $1000 Failure to disclose required information on license

application

11/3/2016 DeGroote, Russell A. MD 2016-001207 114055 Impositon of Civil Fine of $1000 Failure to disclose required information on license

application

11/3/2016 Volz, Sara DO 2016-000874 108577 Impositon of Civil Fine of $1000 Failure to disclose required information on license

application

11/3/2016 Smith, Eolwyn Marie DO 2016-001237 MEDO5154 Consent Agreement with reprimand

and fine of $3,500 w/ $1,500

suspended


license renewal


11/3/2016 Zoltani, John Gregory MD 2016-001236 MEDS6053 Consent Agreement with reprimand

and fine of $3,500 w/ $1,500

suspended


license renewal


11/3/2016 Gurland, Steven Victor MD 2016-001045 MEDS7336 Voluntary Surrender of License Failure to comply with CME requirements in audit of

license renewal


11/3/2016 Boyer, Steve Clair MD 2016-001046 MEDS3936 Voluntary Surrender of License Failure to comply with CME requirements in audit of

license renewal


11/3/2016 Marks, Richard Edward MD 2016-001051 MEDS5719 Consent Agreement with reprimand

and fine of $3,500 w/ $1,500

suspended


license renewal


11/3/2016 Harikian, Larry Allen MD 2016-001052 MEDS2223 Consent Agreement with reprimand

and fine of $3,500 w/ $1,500

suspended


license renewal


11/3/2016 Kiser, Nicole Rae MICP 2016-001044 MEDM798 Consent Agreement with reprimand

and fine of $3,500 w/ $2,500

suspended


license renewal


8/24/2016 Ahmad, Mahmood MD 2015-002049 MEDS7923 License Surrender Board adopted surrender in lieu of potential

revocation of licensure for incompetent/ negligent/

unprofessional opioid prescribing practices


8/5/2016 Chaudhry, Bilal MD 2016-000674 MEDS6527 Imposition of Civil Fine of $1000 Failure to disclose required information on renewal

application

8/4/2016 Ahmad, Mahmood MD 2015-002049 MEDS7923 Decision and order following hearing Board adopted proposed decision to uphold summary

suspension of license


8/4/2016 Bote, Herbert Ortiz MD 2015-001299 MEDS8038 Board order modifying 5/5/16 consent

agreement

Allow additional time to comlete required education All other conditions remain, incl. 90 day suspension, 3 years probation,

additional education, other conditions

Page 5 of 45






DATE OF


8/4/2016 Smith, Charlie Dorn MD 2015-002213 104897 Impositon of Civil Fine of $1000 Failure to disclose required information on license

application

8/4/2016 Garcia, Karen DO 2016-000677 110684 Impositon of Civil Fine of $1000 Failure to disclose required information on license

application

8/4/2016 Haas, Eric MD 2015-000915 MEDS5492 License Surrender Failure to disclose disciplinary action taken by

another jurisdiction


8/4/2016 Shaw, Ashley G. DO 2016-000285 103943 Impositon of Civil Fine of $1000 Failure to disclose required information on license

application

8/4/2016 Betts, William B MD 2014-000927 MEDS6814 Consent Agrement w/ 10,000 fine and

reprimand

Professional incompetence, deviation in standard of

care, by failing to properly treat a patient with a life

threatening condition

8/4/2016 Hutsinpiller, Molly MD 2016-000470 MEDS4246 Nondisciplinary Consent Agreement

with 5 yrs probation/monitoring

Previous impairment issues and license

action/restrictions by other state Boards

Five-yr probation, requirement for counseling/ therapy with reports to

bd, restriction on remote practice, as per Utah order

7/27/2016 Reina, Michelle Renee MD n/a n/a Application withdrawn Application withdrawn due to change in employment

plans

No license issued

5/10/2016 Ahmad, Mahmood MD 2015-002049 MEDS7923 Accusation Alleged professional incompetence, gross

negligence, or repeated negligent conduct; alleged

unprofessional conduct; alleged deceit, fraud, or

intentional misrepresentation while providing

professional services

5/6/2016 Ahmad, Mahmood MD 2015-002049 MEDS7923 Summary Suspension License suspended for unsafe prescribing of

controlled subst, violating practice and recordkeeping

standards posing a clear and immediate danger to

public health and safety


5/5/2016 Brady, Patrick D. MD 2015-000324 MEDS2267 Consent Agreement w/ reprimand,

fine of $5,000

Prescribing legend drugs, controlled subst to ext

family member w/o proper exam, diagnosis,

recordkeeping, follow-up, etc.

5/5/2016 Osterbauer, Peter MD 2016-000323,

2014-000153

MEDS6271 Suspension of License License suspended for non-compliance with of 1/9/14

consent agreement


5/5/2016 Gilbert, Melodye L. PA-C 2015-000434 PADA488 Order to terminate probation Complied with terms of NY consent order None

5/5/2016 Anderson, Jack D. MICP 2015-001765 MEDM372 Imposition of Civil Fine of $1000 Failure to disclose conviction within required

timeframe

None

5/5/2016 Greer, Jordan H. DO 2016-000255 MEDO2266 License Suspension Suspension of license due to results of alcohol

assessment/evaluation, recc to cease practice and

seek prof treatment

Not authorized to practice

5/5/2016 Bote, Herbert Ortiz MD 2015-001299 MEDS8038 Consent Agreement w/ license

suspension, probation, reprimand,

fine of $25,000 ($15,000 susp)

Unprofessional conduct and sexual misconduct re:

inappropriate physical and verbal contact with female

patients

License suspended for 90 days beginning 7/1/16; probation for 3 years,

additional education, other conditions

5/5/2016 Hamilton, Julia Ling-Ling DO 2015-002110 104516 Imposition of Civil Fine of $1000 Failure to disclose required info on application for

resident permit

None

5/5/2016 Pfleger, Mark J. MD 2015-001699 100862 Imposition of Civil Fine of $1000 Failure to disclose required info on license application None

3/24/2016 Lommatzsch, Sherstin MD n/a n/a Application withdrawn Application withdrawn due to change of plans No license issued

3/24/2016 Dubey, Aditya Narayan MD n/a n/a Application withdrawn Application withdrawn due to change of plans No license issued

3/24/2016 Aboulian, Arin MD n/a n/a Application withdrawn Application withdrawn due to change of plans No license issued

Page 6 of 45






DATE OF


3/24/2016 Woodrow, James Piper MD n/a n/a Application withdrawn Application withdrawn due to change of plans No license issued

3/24/2016 Martin, Richard Edwin MD n/a n/a Application withdrawn Application withdrawn, unable to meet licensing

requirements

No license issued

3/24/2016 Kathpal, Madeera DO n/a n/a Application withdrawn Application withdrawn for unspecified reasons No license issued

3/24/2016 Sobti, Vikram Krishnan MD n/a n/a Application withdrawn Application withdrawn for unspecified reasons No license issued

2/11/2016 Wasile, Olga Iris MD 2014-001410 MEDS4987 Board order modifying 8/6/15 consent

agreement

Modification of restricted prescription authority Lifting restricted prescriptive authority w/ quarterly review of patient

charts; all other conditions remain unchanged.

2/11/2016 Johnson, Kenneth H. PA-C 2015-001006 PADA245 Imposition of Civil Fine of $1000 Failure to report a malpractice claim as required by

law

2/11/2016 Greer, Jordan H. DO 2015-001617 MEDO2266 Consent Agreement w/ probation,

reprimand, fine of $3000

Failure to disclose criminal convictions, practice while

license was lapsed

3 yrs probation, alcohol assessment/evaluation, no alcohol or drug use,

other conditions

11/5/2015 Augdahl, Cody MD 2015-001621 102303 Imposition of Civil Fine of $1000 Failure to disclose required info on license application None

11/5/2015 Zwiacher, John W. MD 2014-001116 MEDS5805 Imposition of Civil Fine of $1000 Failure to report hospital privileges action within

required timeframe

None

11/5/2015 Brown, Carl L. PA-C 2014-001577 PADA473 Imposition of Civil Fine of $1000 Failure to file collaborative plan within required

timeframe

None

11/5/2015 Carpenter, Peter MICP 2015-000872 MEDM833 Imposition of Civil Fine of $1000 Failure to file sponsorship change within required

timeframe

None

11/5/2015 Levy, Karen R. MD 2015-000869 105897 Imposition of Civil Fine of $1000 Failure to disclose required info on license application None

11/5/2015 Samuels, Joshua PA-C 2015-000529 PADA299 Imposition of Civil Fine of $1000 Failure to file collaborative plan within required

timeframe

None

11/5/2015 Foss, Jeffrey Frank MD 2015-000908 MEDS6528 License Surrender Failure to disclose disciplinary action taken by

another jurisdiction


11/5/2015 Andrew, Rebecca PA-C 2015-000660 PADA640 Imposition of Civil Fine of $1000 Failure to file collaborative plan within required

timeframe

None

9/17/2015 Ghosh, Shubhranjan MD 2014-000786 MEDS6297 License Suspension Suspension of license due to felony medical

assistance fraud conviction and investigation of

allegations re: prescription, recordkeeping,

alcohol/drug violations


9/17/2015 Massey, Michael D. DO 2015-000136 MEDO2950 License Surrender Failure to report investigation, license revocation in

another state; failure to properly report convictin


9/17/2015 Sundina, Nataliya PA-C 2012-000283 PADA990 Imposition of Civil Fine of $1000 Failure to file Alaska DEA registration

9/17/2015 Odom, David MD 2800-09-0122;

OAH 12-0111-

MED

MEDS1288 Board Decision on Remand from

Appeal to Superior Court

Board re-adopted Div. finding of unprofessional

conduct, professional incompetence, gross

negligence, or repeated negligent conduct, and

practice below the standard of care; ordered license

revocation, effective immediately.


8/21/2015 Odom, David MD 2800-09-0122;

OAH 12-0111-

MED

MEDS1288 Revocation vacated by Superior

Court

Superior Court Order on Appeal, vacating Board's

6/4/14 action and remanding for Board

reconsideration

8/6/2015 McGroarty, John MD 2013-001355 MEDS7347 License Surrender Under investigation Not authorized to practice

8/6/2015 Elrod, Darryl G. MD 2014-002022 MEDS6184 Imposition of Civil Fine of $1000 Failure to report hosp privileges action within the

required timeframe.

None

8/6/2015 Naughton, Thomas Michael MD 2015-000052 MEDS6855 Imposition of Civil Fine of $1000 Failure to report other state license action within the

required timeframe.

None

Page 7 of 45






DATE OF


8/6/2015 Niemi, Michael PA-C 2015-000053 PADA716 Imposition of Civil Fine of $1000 Failure to report conviction within the required

timeframe

None

8/6/2015 Mercer, Minnie A. PA-C 2015-000051 PADA380 License Surrender Under investigation for failing to disclose disciplinary

action on renewal application


8/6/2015 Wasile, Olga Iris MD 2014-001410 MEDS4987 Consent Agreement with reprimand,

probation, conditions

Failure to provide approp care, pain management 3 years probation, mandatory education

8/6/2015 Stone, James R. MD 2014-001248 MEDS6284 Imposition of Civil Fine of $1000 Failure to report malpractice settlement within the

required timeframe.

None

8/6/2015 Randle, Joanie V. PA-C 2015-000654 PADA684 Consent Agreement with reprimand

and fine of $1,000

Practice while license was lapsed None

8/6/2015 Winklmann, John PA-C 2015-000658 PADA20 Imposition of Civil Fine of $1000 Failure to file collaborative plan within required

timeframe

None

8/6/2015 Boomgaard, Kenneth MD 2015-000641 100248.00 Imposition of Civil Fine of $1000 Failure to disclose required info on license application None

8/6/2015 Boespflug, Randy MD 2015-000042 MEDS6361 Consent Agreement License action in another state w/ required medical

education, 5 year probation

must comply w/ Oregon order, including practice limitations on

treatment and prescribing

7/15/2015 Herring, Vanessa R. MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

5/29/2015 Loffarelli, John Joseph MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

5/16/2015 Copeland, Jeffrey J. DO 2012-000231 MEDO7469 Released from Confidential


adopted 5/17/12

Confidential issues not related to practice None

5/7/2015 Michaud, Michael PA-C 2014-001249 PADA1165 Imposition of Civil Fine of $1,000 Failure to file Alaska DEA registration None

5/7/2015 Spurlock, Lisa X. PA-C 2014-002346 PADA1171 Imposition of Civil Fine of $1,000 Failure to file Alaska DEA registration None

5/7/2015 Makim, Jayesh D. MD 2014-1765 MEDS3215 License Surrender Failure to report DUI conviction and impairment

issues


5/7/2015 Babcock, Nita K. MD 2015-000383 MEDS8317 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

5/7/2015 Allen, Lance O. DO 2015-000381 MEDO8306 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

5/7/2015 Lange, Tanya MICP 2014-001482 MEDM660 Board order modifying 2/5/15 consent

agreement

Allow additional time to pay fine

5/5/2015 Brown, Carl L. PA-C 2014-001577 PADA473 Accusation Practice without a collaborative plan

4/20/2015 Wagner, Lloyd David MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

2/5/2015 Dahle, Aaron Daniel PA-C 2014-001053 PADA980 Consent Agreement with reprimand

and fine of $1,000

Practice without a collaborative plan in effect None

2/5/2015 Gilbert, Melodye L. PA-C 2014-001247 PADA488 Consent Agreement with reprimand

and fine of $1,000

Failure to properly report license action in other state Probation, req to comply with terms of NY consent order

2/5/2015 Liu, Steven Y. MD 2010-000422 MEDS5645 Consent Agreement with reprimand

and fine of $1,000

Failure to disclose required information on renewal

application

None

2/5/2015 Beckworth, Dennis MD 2010-000420 MEDS4225 Consent Agreement with reprimand

and fine of $1,000

Failure to disclose required information on renewal

application

None

2/5/2015 Grindeland, Isaac R. MD 2014-001772 MEDS8277 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

2/5/2015 McFadden, Dennis S. DO 2014-002345 MEDO8258 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

2/5/2015 Blackadar, Charles S. MD 2014-001769 MEDS8250 Consent Agreement with reprimand

and fine of $1,000

Failure to disclose required information on license

application

None

Page 8 of 45






DATE OF


2/5/2015 Patton, Paul Lin PA-C 2014-001485 PADA1214 Confidential Nondisciplinary Consent

Agreement

Confidential issues not related to practice

2/5/2015 Spencer, Roger W. MD 2014-002023 MEDS8246 Confidential Nondisciplinary Consent

Agreement

Confidential issues not related to practice

2/5/2015 Lange, Tanya MICP 2014-001482 MEDM660 Consent Agreement with reprimand

and fine of $3,500 w/ $2,500

suspended


license renewal


1/22/2015 Thompson, Robert G. MD 2013-000609;

2010-000823

MEDS2047 Probation Ended Satisfied terms of 5-yr probation

12/5/2014 Madar, Mercedes G. MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

12/5/2014 Jones, Mark Clayton MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

11/6/2014 Critchlow, Allison DO 2014-001579 MEDO8242 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

11/6/2014 James, Matthew T. PA-C 2014-000258 PADA969 Imposition of Civil Fine of $1,000 Failure to report DUI conviction as required None

11/6/2014 Craver, Kenric B. PA-C 2014-000954 PADA1025 Consent Agreement with reprimand,

fine of $1000

Practicing without NCCPA certification None

11/6/2014 Guthrie, William J. DO 2014-001845 MEDO8272 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

11/6/2014 Shergill, Ravinder MD 2014-001580 MEDS8245 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

10/30/2014 Merchant, Clifford R. MD 2014-002041 MEDS1552 License Surrender Board adopted surrender in lieu of potential

revocation of licensure for indictments of sexual

abuse of a minor


10/24/2014 Salard, Greg A. MD 2014-002016 MEDS6576 License Surrender Board adopted surrender in lieu of potential

revocation of licensure for federal indictments of

possession and distribution of child pornography


8/26/2014 Laine, Edward Paul DO 2014-001415 Application withdrawn Application withdrawn while under investigation for


process.

No license issued

8/14/2014 Myers, Robert MD 2014-001374 MEDS8168 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

8/14/2014 Rossi, Daniel C. DO 2014-001229 MEDO8167 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

8/14/2014 Faerber, Wade DO 2014-001414 MEDO8166 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

8/14/2014 Murphy, Colleen MD 2013-001463 MEDS3162 Imposition of Civil Fine of $1,000 Failure to disclose required info on renewal

application (technical violation not related to patient

care)

8/14/2014 Mandich, Maria MD 2014-001105 MEDS5413 Consent Agreement with reprimand

and fine of $3,500 w/ $1,000

suspended


license renewal


8/14/2014 Zimmerman, Mark J. MD 2013-002186 MEDS2125 Voluntary Surrender of License Failure to comply with CME requirements in audit of

license renewal


7/31/2014 deWolfe, Melissa Ann DO

Application withdrawn Application withdrawn due to change in employment

plans

No license issued

7/31/2014 Chasteen-Seibert, Cheryl A. PA-C


plans

No license issued

Page 9 of 45






DATE OF


7/31/2014 Gal, Christine Tsu Norred MD


plans

No license issued

7/31/2014 DeRoo, Teresa A. MD


plans

No license issued

7/31/2014 Brownlee, John David MD Application withdrawn Application withdrawn for unspecified reasons No license issued

7/31/2014 Sykes, Charles Louis MD Application withdrawn Application withdrawn for personal reasons No license issued

7/31/2014 Callahan, Debra Louise MD


plans

No license issued

7/30/2014 Miller, Barry David MD 2013-001721 Cease & Desist Order Practiced med w/out a license Not licensed in AK

7/28/2014 Daniel, Stephen MD 2011-000390 MEDS5318 Released from Confidential


adopted 7/28/11


6/5/2014 Williams, Marcus Rey MD 2800-08-023 MEDL4913 Order terminating conditions of

5/12/11 probation agreement

Not residing/practicing in Alaska Not currently licensed in Alaska

6/5/2014 Rolinger, Megan M. PA-C 2012-001340 PADA1013 Imposition of Civil Fine of $1,000 Failure to file DEA registration None

6/5/2014 Hasenauer, John PA-C 2013-002166 PADA1050 Imposition of Civil Fine of $1,000 Failure to disclose required info on license renewal

application

None

6/5/2014 Roberts, David T. MD 2014-000761 MEDS8077 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

6/5/2014 Gabel, Andrea L. MD 2014-000477 MEDS8049 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

6/5/2014 Biskup, Toni Marie MD 2014-000760 MEDS8037 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

6/5/2014 Odom, David MD 2800-09-0122;

OAH 12-0111-

MED

MEDS1288 Decision and order following hearing Board adopted Div. finding of unprofessional conduct,

professional incompetence, gross negligence, or

repeated negligent conduct, and practice below the

standard of care; ordered license revocation

Revocation effective 7/17/14 Cannot practice in Alaska after that date

4/9/2014 Ting, Juk Ling DO 2013-002363 MEDO8027 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

4/9/2014 Grandstaff, Phillip M. MD 2014-000084 MEDS8050 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

4/9/2014 Ottaviano, Paul G. MD 2014-000082 MEDS8071 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

4/9/2014 Valley, Thomas C. MD 2012-000922 MEDS7410 Voluntary Surrender of License Under investigation for allegations of professional

misconduct


4/9/2014 Pomeroy, Michael J. PA-C 2012-001287 PADA179 Imposition of Civil Fine of $1,000 Failure to disclose investigation/license action on

renewal application

4/9/2014 Mercer, Minnie A. PA-C 2011-000930 PADA380 Imposition of Civil Fine of $1,000 Failure to obtain a DEA registration for Alaska

practice site

4/9/2014 Smith, Robert S. MD 2013-002167 MEDS7471 Imposition of Civil Fine of $1,000 Failure to disclose investigation/license action on

renewal application

4/9/2014 Zaremba, Claudette A. MD 2013-002168 MEDS6245 Imposition of Civil Fine of $1,000 Failure to disclose investigation/license action on

renewal application

4/9/2014 Johnson, Jill M. PA-C 2014-000229 PADA405 Imposition of Civil Fine of $1,000 Failure to file collaborative plan within required

timeframe

None

4/9/2014 Plasil, Brian J. MD 2014-000246 MEDS6333 Consent Agreement with reprimand

and fine of $3,500 w/ $1,000

suspended


license renewal


3/6/2014 Abadir, Janet S. MD 2014-000220 MEDS8017 Imposition of Civil Fine of $1,000 Failure to disclose required info on license application None

Page 10 of 45






DATE OF


3/6/2014 Lam, Virginia Hoon Moy PA-C 2013-002279 PADA1065 Consent Agreement with reprimand,

fine of $1,000

Practice without a collaborative plan in effect

3/6/2014 Kopp, James R. MD 2013-002408 MEDS7934 Consent Agreement with reprimand,

fine of $1,00

Failure to disclose previous counseling/alcohol

referral on license application

3/6/2014 Ferucci, Paul G. MD 2013-002187 MEDS5098 Consent Agreement with reprimand

and fine of $2,750 w/ $1,750

suspended


license renewal


3/6/2014 Copass, Michael MD 2012-000641 MEDS6129 Voluntary Surrender of License Failure to comply with CME requirements in audit of

license renewal


3/6/2014 Allgood, Norma L. MD 2013-001968 MEDS6781 Order vacating consent agreement

adopted 10/17/13

Extenuating circumstances regarding late compliance

with CME audit

None

3/6/2014 Scheck, John R. MD 2011-000818 MEDS6967 Consent Agreement with probation,

conditions

Failure to provide approp wound care 6 months probation, mandatory education

3/6/2014 McPherson, Cynthia M. PA-C 2013-002124 PADA906 Consent Agreement with reprimand,

fine of $1,000


3/6/2014 Sherrill, Kimberly MD 2014-000245 MEDS5573 Consent Agreement with reprimand

and fine of $3,500 w/ $1,000

suspended


license renewal


3/6/2014 Tien, Bertha MD 2014-000244 MEDS5024 Consent Agreement with reprimand

and fine of $3,500 w/ $1,000

suspended


license renewal


1/9/2014 Osterbauer, Peter MD 2013-001005 MEDS6271 Order lifting suspension of license

and new Consent Agreement with

reprimand, fine of $10,000, and 10

years probation

Lifted 7/18/13 suspension subject to conditions of

new consent agreement

10 years probation with reporting and treatment provisions; total

permanent abstinence.

1/9/2014 Sullivan, Michelle A. MICP 2010-000822 MEDM353 Voluntary Surrender of License Voluntary surrender of license until able to comply

with Board ordered conditions and can demonstrate

fitness to practice safely


1/9/2014 Cotton, Yolanda M. PA-C 2013-002123 PADA997 Consent Agreement with reprimand

and fine of $1,000


1/9/2014 Millstein, Karen L. PA-C 2013-001922 PADA292 Imposition of Civil Fine of $1,000 Failure to provide complete information regarding

new collaborative plan

None

1/9/2014 Perino, Vincent M. PA-C 2013-002367 PADA1144 Imposition of Civil Fine of $1,001 Failure to disclose other state licenses on new license

application

None

1/9/2014 Glenn, Kelly R. DO 2013-002263 MEDO7925 Imposition of Civil Fine of $1,000 Failure to disclose other state licenses on new license

application

None

11/25/2013 Ahmad, Mahmood MD 2013-001803 MEDS7923 Consent Agreement with reprimand

and fine of $1000

Failure to disclose other state investigation/ action on

license application

Comply with Arkansas agreement

10/25/2013 Tomczyk, Jakub MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

10/25/2013 Douglas, James G. MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

10/25/2013 Gomez, Richard MD Application withdrawn Application withdrawn for unspecified reasons No license issued

10/25/2013 Howard, Rory James MD Application withdrawn Application withdrawn for unspecified reasons No license issued

10/25/2013 Fitts, William E. MD MEDS2222 Application withdrawn Application withdrawn due to change in employment

plans

Expired license not reinstated

10/17/2013 Sullivan, Michelle A. MICP 2010-000822 MEDM353 Voluntary Suspension of License Voluntary suspension of license until able to comply

with Board ordered conditions and can demonstrate

fitness to practice safely


10/17/2013 Mayer, Frederick W. MD 2013-001052 MEDS7918 Imposition of Civil Fine of $1,000 Failure to disclose malpractice information on license

application

None

Page 11 of 45






DATE OF


10/17/2013 Allgood, Norma L. S 2013-001968 MEDS6781 Consent Agreement with reprimand

and fine of $2,800 w/ $1,800

suspended


license renewal


10/17/2013 Ditzler, John R. MICP 2013-001477 MEDM390 Confidential Nondisciplinary Consent

Agreement


10/17/2013 Killebrew, David S. MD 2800-99-007;

OAH 04-0234-

MED

MEDS2656 Probationary period ended early Exeptional progress, promise to continue monitoring No restrictions; permanent conditions remain including PHC

monitoring, permanent total abstinence

10/17/2013 Schurig, Samuel H. DO 2802-07-005 MEDO1967 Board Order Modifying MOA Board allowed limited supervision modifications from

10/17/13 thru 10/17/14

Conditions of MOA remain, incl. 10 yrs probation, psychotherapy,

prohibition against remote practice, rquired supervised practice by a

board-approved physician, restricted prescriptive authority, rquired

actively-licensed chaperone when treating female pts, cannot supervise

PAs.

9/18/2013 Liscord, Emory Elizabeth MD Application withdrawn Application withdrawn due to change in educational

plans

No license issued

9/18/2013 Stassi, Mandy Michele MICP Application withdrawn Application withdrawn for unspecified reasons No license issued

9/18/2013 Lampsa, Diana Jean MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

9/18/2013 Marwah, Gurit Singh MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

9/18/2013 Jones, John Kipling MD Application withdrawn Application withdrawn due to change in employment

plans

No license issued

9/18/2013 Taylor, Daniel M. MICP MEDA6567 Application withdrawn Application withdrawn due to change in employment

plans

Permanent license not issued; temp permit expired 3/10/2013

7/18/2013 Beirne, Mark J. MD 2013-000617;

2011-000241

MEDS2477 Rescind requirement to resinstate AZ

license

Board recognized unniqe circumstance re: AZ

licensing and agreed to rescind the requirment to

reinstate the AZ licens

All other conditions of consent agreement remain

7/18/2013 Osterbauer, Peter MD 2013-001005 MEDS6271 Order for Suspension of License Board suspended license for violating conditions of

5/12/11 nondisc consent agreement w/ probation and

conditions


7/18/2013 Higgins, Michael J. MD 2013-000831 MEDS7750 Imposition of Civil Fine of $1,000 Failure to disclose malpractice information on license

application

None

7/18/2013 Komaiha, Hamed Aly MD 2013-000566 MEDS5330 Imposition of Civil Fine of $1,000 Failure to disclose malpractice information on license

application

None

7/18/2013 Hill, Diane E. PA-C 2013-000573 PADA802 Consent Agreement with reprimand

and fine of $1000


7/18/2013 Crawford, William L. PA-C 2013-000573 PADA869 Consent Agreement with reprimand

and fine of $1000


7/18/2013 Bay, Rebecca I. MD 2013-000241 MEDS5021 Consent Agreement with civil fine of

$1,000 and a reprimand


7/18/2013 Royal, Erin Marie MD 2013-000568 MEDS7795 Imposition of Civil Fine of $1,000 Failure to disclose history information on license

application

None

7/18/2013 Skopec, Timothy Martin MD 2012-000374 MEDS7803 Imposition of Civil Fine of $1,000 Failure to disclose malpractice claim information on

license application

None

7/18/2013 Cooper, Allison M. PA-C 2012-001335 PADA1123 Imposition of Civil Fine of $1,000 Failure to disclose academic probation on license

application

None

7/18/2013 Manley, Charles G. MICP 2012-001538 MEDM266 Nondisciplinary Consent Agrmt Exemption for some of the required CME for license

renewal

None

7/18/2013 Bartling, Victor K. DO 2010-000882;

OAH 12-0221-

MED

MEDO2557 Decision and order following hearing Board adopted proposed decision finding that Dr.

provided approp. Care; incomp/negligence/ unprof

conduct NOT proven

Page 12 of 45






DATE OF


7/18/2013 Meyers, Corey John MD 2011-000437 MEDS4973 Decision and order following hearing Board adopted proposed decision for license

revocation and 1,500 civil fine; failure to disclose

license revocation in other state(s)


6/27/2013 Berg, Tracy Ann MD none Application withdrawn Withdrew application due to change in employment

plans

No license issued

6/27/2013 Windham, Wayne Weaver MD none Application withdrawn Withdrew application for unspecified reasons No license issued

6/27/2013 Carr, Robert "Wade" MICP none Application withdrawn Withdrew application for unspecified reasons No license issued

6/20/2013 Frazier, Jerome DO none MEDH6702 Application withdrawn Withdrew application for unspecified reasons Permanent license not issued; temporary permit expired 5/16/13

6/20/2013 Park, Michelle Maria MD none Application withdrawn Withdrew application for unspecified reasons No license issued

6/20/2013 Ruetzel, Craig Heiner MD none Application withdrawnWithdrew application due to change in employment

plans

No license issued

6/20/2013 Edelman, Harlan David MD none MEDT6746 Application withdrawn Withdrew application for unspecified reasons Permanent license not issued; temporary permit expired 6/24/2013

5/22/2013 Lieberson, Robert E. MD 2012-001341 MEDS7704 Imposition of Civil Fine of $1,000 Failure to disclose history information on license

application

None

4/27/2013 Beirne, Mark J. MD 2013-000617;

2011-000241

MEDS2477 Rescind reprimand and fine; extend

time to resinstate AZ license

Allow through July 30, 2013 to reinstate AZ license;

reconsider compliance with Consent Agt at July 2013

meeting

Conditions of consent agreement remain

4/19/2013 Kerr, Glenn E. MD 2013-000397 MEDT6656 Application withdrawn while under

active investigation

Withdrew application during investigation of alleged

violations of telemedicine practice

Temporary permit expired 3/ 20/13; permanent license not issued

4/5/2013 Scheck, John R. MD 2011-000818 MEDS6967 Accusation Alleged professional incompetence, lacking sufficient

knowledge, skills, or professional judgement, not

conforming to generally accepted standards of

practice

3/28/2013 Knoll, James L. MD 2012-000647 MEDS6431 Acknowledge rect of CME, but upheld

reprimand/fine for violation


license renewal


3/28/2013 Beirne, Mark J. MD 2013-000617;

2011-000744

MEDS2477 Reprimand and fine for violating

existing Consent Agreement

Failure to comply with requirements to reinstate his

Arizona license


3/28/2013 Mickleson, Dennis Lynn MD 2013-000606;

2010-000816


existing MOA; fine suspended while

license in inactive status

Failure to comply with probation requirements upon

return to Alaska

May not practice with inactive status license; conditions of MOA remain

3/28/2013 Sullivan, Michelle A. MICP 2013-000615;

2010-000822

MEDM353 Reprimand and fine for violating

existing Consent Agreement; fine

suspended if compliance

Failure to comply with requirements to advise Board

of employment

No direct patient care; all conditions of consent agreement remain

3/28/2013 Thompson, Robert G. MD 2013-000609;

2010-000823


existing Consent Agreement

Failure to comply with requirements to pay a fine and

complete specific CME

Conditions of consent agreement remain; must also pay fine and

complete CME

3/28/2013 Fitzgerald, Kevin MICP 2012-000634 MEDM493 Voluntary Surrender of License Failure to comply with CME requirements in audit of

license renewal


3/28/2013 Cameron, Stefany J. PA-C 2012-001246 PADA1100 Imposition of Civil Fine of $1,000 Failure to disclose academic probation on license

application

None

3/28/2013 Downey, James R. MD 2012-001528 MEDS7702 Imposition of Civil Fine of $1,000 Failure to disclose academic probation on license

application

None

3/28/2013 Neuzil, Daniel F. MD 2012-000989 MEDS7703 Imposition of Civil Fine of $3,000 Failure to disclose malpractice info on license

application

None

3/5/2013 Dean, David Franklin MD none Application withdrawn Withdrew application for unspecified reasons No license issued

Page 13 of 45






DATE OF


2/21/2013 Nelson, Kay Lorraine MD none MEDT6704 Application withdrawn Withdrew application due to change in employment

plans

Temporary permit expires 5/16/2013

1/17/2013 Rogers, Donald Robert MD 2012-001536 MEDT708 Nondisciplinary Consent Agrmt Extension of time to obtain required CME for license

renewal

None

1/17/2013 Nye, Brianna H. PA-C 2012-001334 PADA1075 Imposition of Civil Fine of $1,000 Failure to disclose academic probation on license

application

None

1/17/2013 Knoll, James L. MD 2012-000647 MEDS6431 Consent Agreement with reprimand

and fine of $3,500 w/ $2000

suspended


license renewal


1/17/2013 Totten, Mary C. MD 2012-000643 MEDS4768 Consent Agreement with reprimand

and fine of $3,500 w/ $2000

suspended


license renewal


1/17/2013 Kaniadakis, Steven J. DPM MEDP2981 Denial of application to reinstate

revoked license

Previous federal convictions for fraud and

unprofessional conduct.


1/3/2013 Yunker, Stanley Brett MD none Application withdrawn Withdrew application for unspecified reasons No license issued

1/3/2013 Enoch, Joan Ellen MD none Application withdrawn Withdrew application due to change in employment

plans

No license issued

1/3/2013 Godat, David Michael MD none Application withdrawn Withdrew application for unspecified reasons No license issued

1/3/2013 Bost, Richard Magnus MD none Application withdrawn Withdrew application for unspecified reasons No license issued

1/3/2013 Kilshtok, Sofya Stanislavovna MD none Application withdrawn Withdrew application due to change in employment

plans

No license issued

1/3/2013 Botway, Natasha L. MICP 2012-001068 Application withdrawn while under


Failed to disclose academic probation during

paramedic training program; failed to appear for

board interview


8/20/2012 Haase, Harold F. MD 2012-000901 MEDS7610 Imposition of Civil Fine of $1,000 Failure to disclose prev. fine by another board on

license application

None

8/20/2012 Andress, Daniel M. MD 2012-000897 MEDS7537 Imposition of Civil Fine of $1,000 Failure to disclose prev. academic probation on

license application

None

7/27/2012 Beirne, Mark J. MD 2011-000241 MEDS2477 Board Order Modifying Consent

Agreement

Board allowed addl. 6 mo to reinstate Arizona license All other conditions remain, incl. limitations/restrictions as provided in

agreement; 10 yr. probation to monitor progress; permanent total

abstinence

7/26/2012 Schurig, Samuel H. DO 2802-07-005 MEDO1967 Board Order Modifying MOA Board allowed limited supervision modifications from

7/26/12 thru 7/26/13

Conditions of MOA remain, incl. 10 yrs probation, psychotherapy,

prohibition against remote practice, rquired supervised practice by a

board-approved physician, restricted prescriptive authority, rquired

actively-licensed chaperone when treating female pts, cannot supervise

PAs.

7/26/2012 Kindell, Gary MD 2010-000495

2011-000187 et

al

MEDS6365 Consent Agreement with reprimand,

fine of $14,000, addl education, and 5

years probation

Overprescribing pain meds Complete addl. Education, probation to monitor practice, chart review

by pain mgt specialist

7/26/2012 Hasenauer, John PA-C 2012-000617 PADA1050 Consent Agreement with reprimand

and fine of $2000

Failure to disclose previous board action on license

application

None

7/25/2012 Hartig, Glenn Stuart DO 2802-07-001 MEDO4523 Probation Ended Satisfied terms of 5-yr probation Permanent restriction against alcohol/drug consumption

7/13/2012 Bartling, Victor K. DO 2010-000882 MEDO2557 Accusation Alleged professional incompetence and/or gross

negligence, and repeated negligent conduct

Page 14 of 45






DATE OF


5/17/2012 Miller, Timothy DO 2012-000373 MEDC5233 Consent Agreement with reprimand

and fine of $1000

Failure to disclose adverse residency program

information on license application

None

5/17/2012 Smith, Robert S. MD 2012-000419 MEDS7471 Imposition of Civil Fine of $1,000 Failure to disclose all states of licensure on license

application

None

5/17/2012 Copeland, Jeffrey J. DO 2012-000231 MEDO7469 Confidential Nondisciplinary Consent

Agreement


5/4/2012 Wexner, Sage MD none Application withdrawn Withdrew application for unspecified reasons No license issued

4/20/2012 Odom, David MD 2800-09-012 MEDS1288 Accusation Alleged substandard care, professional

incompetence, gross negligence, repeated negligent

conduct, unprofessional conduct

4/9/2012 McQuinn, Tim Charles MD none Application withdrawn Withdrew application for unspecified reasons No license issued

4/9/2012 Miller, Wayde Dirk MD none Application withdrawn Withdrew application due to change in employment

plans

No license issued

3/14/2012 Whittier, Tracy L. PA-C none Application withdrawn Withdrew application for unspecified reasons No license issued

2/23/2012 Miller, Mark H. MD none Application withdrawn Withdrew application due to change in employment

plans

No license issued

1/29/2012 Palmer, William M. MD 2800-08-020 MEDS1092 Probation Ended Satisfied terms of 3-yr probation None

1/27/2012 Meyers, Corey John MD 2011-000437 MEDS4973 Accusation Revocation of license in New York; alleged

falsification/nondisclosure on renewal application

1/26/2012 Zwiaicher, John MD 2800-10-003 MEDS5805 Consent Agreement with reprimand,

fine of $1000, continuing education

required

Investigation of standard of care complaint;

nondisclosure of investigation

None; additional education required

1/26/2012 Borden, James B. MD 2800-05-004 MEDS1176 Consent Agreement with reprimand

and fine of $1,000

Investigation of suspension of hospital privileges

resulted in 12/7/09 license revocation; Board agreed

to vacate revocation and impose terms of consent

agreement

Cannot practice in AK - license expired 12/31/04

1/26/2012 Meyers, Corey John MD 2011-000437 MEDS4973 Order for Suspension of License Board suspended license based on license

revocation in NY for gross negligence, gross

incompetence, failure to maintain accurate patient

care records, fraud, and false report.


1/26/2012 Whitaker, Timothy S. MD 2011-001212 MEDS7342 Consent Agreement with reprimand

and fine of $1,000

Failure to disclose academic, licensing, and

investigation information on application for licensure

None

1/26/2012 Youngstrom, Eric MD 2012-000073 MEDS4792 Confidential Nondisciplinary Consent

Agreement


1/26/2012 Zaremba, Claudette A. MD 2011-000109 MEDS6245 Consent Agreement with reprimand

and fine of $1,000


1/26/2012 Bender, Thomas R. MD 2011-000628 MEDS844 Consent Agreement with reprimand

and fine of $3,500 w/ $2000

suspended


license renewal


1/26/2012 Hemry, David A. MD 2011-000632 MEDS1173 Consent Agreement w/ reprimand

and fine of $3,500


license renewal


1/18/2012 London, Mark J. MD none Application withdrawn Withdrew application - med school not approved No license issued

Page 15 of 45






DATE OF


11/30/2011 Johnson, Donald MD 2011-000888 MEDS7237 Voluntary Suspension of License Voluntary suspension of license while under

investigation of allegations re: patient abandonment,

domestic violence and license suspension in WA


10/27/2011 Richey, Karl E. MD 2011-000222 MEDS2644 Imposition of Civil Fine of $1,000 Failure to disclose investigation information on

renewal application

None

7/28/2011 Kohler, Erik P. MD 2800-08-002 MEDS5237 Decision and Order following hearing Board adopted decision to restrict license Restrictions include supervision of specific practices and chart review

7/28/2011 French, Heather L. MICP 2011-000167 MEDM520 Consent Agreement with reprimand

and fine of $1000

Practice without a supervising physician

7/28/2011 Massey, Michael DO 2011-000294 MEDO2950 Consent Agreement with reprimand,

fine of $2000, and five years

probation

Failure to disclose alcohol and conviction issues on

renewal application; alcohol issues not related to

practice

Limitations as provided in agreement; probation to monitor practice;

permanent total abstinence

7/28/2011 Lee, Laurence MD 2011-000346 MEDS7201 Nondisciplinary Consent Agreement Confidential issues not related to practice None

7/28/2011 Proler, Meyer MD 2011-000367 MEDS6371 Consent Agreement with reprimand

and fine of $1000

Failure to disclose investigation information on

renewal application

None

7/28/2011 Ramerth, Teresa S. MD 2011-000520 MEDL6038 Imposition of Civil Fine of $1,000 Failure to disclose all states of licensure on license

application

None

7/28/2011 Plous, Ronley H. MD 2011-000641 MEDS7212 Imposition of Civil Fine of $1,000 Failure to disclose all states of licensure on license

application

None

7/28/2011 Daniel, Stephen MD 2011-000390 MEDS5318 Confidential Nondisciplinary Consent

Agreement


7/28/2011 Beirne, Mark J. MD 2011-000241 MEDS2477 Consent Agreement with ten yrs

probation/monitoring

Impairment issues; license surrender under

accusation in Alaska and Arizona

Limitations/restrictions as provided in agreement; probation to monitor

progress; permanent total abstinence

6/24/2011 Fenger, Jesse T. PA-C 2856-08-001

2806-09-005

PADA728 License surrender License surrendered under accusation of practice

without a collaborative plan in effect, sexual

misconduct with patient, ethics violations


6/17/2011 Alvarez, Rene L. MD 2011-000197 MEDS2272 Imposition of Civil Fine of $1000 Failure to disclose 10/28/10 Consent Agreement on

license renewal application

Limitations as provided in previous agreement

5/13/2011 Zientek, Gary MD 2850-09-005 MES6754 Order to reinstate Early release from probation/monitoring None

5/13/2011 Cooper, James C. MD 2850-10-004 Decision and Order following hearing Board adopted decision to uphold license denial No license issued

5/12/2011 Yost, Ann-Marie MD 2850-05-003 MEDS5600 Consent Agreement Compromise and settlement of issues raised in

lawsuit appealing previous board action;

reconsideration of 4/21/05 MOA; upon

reconsideration, the MOA was upheld with NPDB

report wording revised

5/12/2011 Williams, Marcus Rey MD 2800-08-023 MEDL4913 Consent Agreement with reprimand, 5

yrs probation monitoring, practice

restrictions

Practicing while impaired by alcohol Limitations as provided in agreement, permanent total abstinence

5/12/2011 Demers, Mary DO 2802-10-001 MEDO3359 Consent Agreement with reprimand,

fine of $5000, and one year probation

Authorizing medical assistants to issue improper

prescriptions

Limitations as provided in agreement

5/12/2011 Osterbauer, Peter MD 2011-000385 MEDS6271 Nondisciplinary Consent Agreement

with 3 yrs probation/monitoring

Alcohol issues not related to practice No practice restrictions; probation to monitor progress; permanent total

abstinence

5/12/2011 Pomeroy, Michael J. PA-C 2010-000511 PADA179 Consent Agreement with reprimand

and fine of $1000


3/21/2011 Tomberlin, Charles Gary MD none Application withdrawn Withdrew application for unspecified reasons No license issued

Page 16 of 45






DATE OF


3/17/2011 Kohler, Erik Peter MD 2800-08-002 MEDS5237 2nd Amended accusation Alleged professional incompetence, gross

negligence, repeated negligent conduct,

unprofessional conduct (31 counts)

3/4/2011 Kohler, Erik Peter MD 2800-08-002 MEDS5237 Amended accusation Alleged professional incompetence, gross


unprofessional conduct (8 counts)

2/22/2011 Elterman, Floyd L. MD 2010-001094 MEDS1802 License Surrender License surrendered while under investigation No longer licensed in AK

1/21/2011 Donaldson, Brian R. MD 2800-01-086

et.al.

MEDS1948 Board Order Modifying MOA Board revised reporting to annual basis, eliminate

sign, eliminate DEA restriction

Conditions of MOA remain, incl. therapy req., female chaperone,

practice monitoring

1/21/2011 Sykes, William M. MD 2800-07-029 MEDS3538 Consent Agreement w/ civil fine

of $1000

Failure to disclose all states of licensure on license

application; vacated 4/3/08 denial, replaced with

consent agreement

None

1/21/2011 Migden, Douglas R. DO 2802-09-004 MEDO2135 Decision and order following hearing Board adopted amended decision imposing civil fine

of $1,000 for failure to disclose a prior investigation

on license application

None

1/20/2011 Burgess, Charles Frank MD 2010-001132 MEDS3113 Nondisciplinary Consent Agrmt Extension of time to obtain required CME for license

renewal

None

1/20/2011 Baldwin, Charles C. MD 2010-000962 MEDS7085 Imposition of Civil Fine of $1,000 Failure to disclose all states of licensure on license

application

None

1/13/2011 Fenger, Jesse T. PA-C 2856-08-001

2806-09-005

PADA728 Accusation Alleged practice without a collaborative plan in effect,

sexual misconduct with patient, ethics violations

12/30/2010 Zwiacher, John MD 2800-10-003 MEDS5805 Accusation Alleged substandard care, professional

incompetence, negligent conduct; alleged falsified

renewal application

12/21/2010 Kohler, Erik Peter MD 2800-08-002 MEDS5237 Accusation Alleged professional incompetence, gross


unprofessional conduct

10/28/2010 Ilardi, Frank MD 2850-10-002 MEDS2446 Decision and order following hearing Board adopted proposed decision upholding their

license denial


10/28/2010 Leslie-Theall, Cheryl-Ann PA-C 2010-000402 PADA483 Consent Agreement w/ reprimand

and fine of $4,000

Falsified renewal application; failure to report

malpractice settlement; failure to timely file

collaborative plan

Addl. CME required

10/28/2010 List, Jerome O. MD 2800-10-010 MEDS2607 Consent Agreement w/ reprimand

and fine of $3,500


09-10 license period

Mandatory audit of CME for next 2 licensing periods

10/28/2010 Jordan, H. James MD 2010-000736 MEDS1093 Consent Agreement w/ reprimand

and fine of $3,500




10/28/2010 Alvarez, Rene L. MD 2010-000641 MEDS2272 Consent Agreement Surrender of hospital surgery privileges Comply with hospital agreement

10/28/2010 Brandner, Michael D. MD 2800-09020 MEDS3478 Board Order Order to submit to psychiatric/medical evaluation

7/29/2010 Rodgers, Thomas Albert MD 2800-10-0005 MEDS3619 Consent Agreement w/ reprimand

and fine of $3,500




7/29/2010 Ray, Tracy D. PA-C 2806-10-002 PADA733 Consent Agreement w/ reprimand

and fine of $5,000

Outside standard of care in dispensing uncontrolled

medications believed to be Vicodin; failed to report

missing medications

7/29/2010 Eule, James M. MD 2800-10-009 MEDS4906 Consent Agreement w/ reprimand

and fine of $1,000

Did not report settlement of malpractice case within

30 day time limitation

None

7/29/2010 Kessler, Adam D. PA-C 2010-000396 PADA813 Consent Agreement w/ reprimand

and fine of $1,000

Practiced without a collaborative plan in effect.

7/21/2010 Winczura, John A. PA-C 2806-05-001 PADA441 Probation Ended Satisfied terms of 5-yr probation Permanent restriction against alcohol/drug consumption

Page 17 of 45






DATE OF


5/27/2010 Mackie, Scott P. MD 2800-06-080

et.al.

MEDS1229 Voluntary Surrender Violations of AS 08.64.326(a) (4)(C), (a)(5), (a)(8)(B)

and 12 AAC 40.975, all relating to illegal sale or

dispensing or drugs, procured, sold, prescribed or

dispensed drugs in violation of law, addiction to or

severe dependency on or habitual overuse of alcohol

or drugs that impairs ability to pract safely, and

prescribing controlled subst.


4/15/2010 Steinhilber, Ernest John MD 2800-06-003 MEDS4134 License Surrendered Voluntary surrender based on revoked lic in NY,

suspended lic in VA, and surrendered licenses in CT,

KY, MA, and PA.


4/15/2010 Rittger, Kevin Duane MD 2800-10-003 MEDS6871 Consent Agreement, civil fine of

$3,500, reprimand, mandatory CME

audit for two licensing cycles


2001-2002 licensing period


4/15/2010 Fenger, Jesse Thomas PA-C 2806-09-005 PADA728 Summary Suspension Suspended for sexual misconduct Cannot practice in Alaska

4/15/2010 Okasinski, Robert E. MD 2850-10-001 MEDS6870 Consent Agreement w/ civil fine of

$1,500 and reprimand

Failure to disclose three states of licensure in his

initial application for Alaska license

None

4/15/2010 Richey, Karl Everett MD 2800-10-001 MEDS2644 Consent Agreement w/ civil fine of


Failure to report malp settlement as required by law None

4/15/2010 Mickleson, Dennis Lynn MD 2800-09-014 MEDS2638 Amended Consent Agreement Reduced number of random drug screens to 14/yr;

allowed prac w/ ANP or PA-C as long as supv phy

involved; as long as phy supv approved part-time

positions

All other provisions of probation remain the same

3/19/2010 Oxford, Jennifer Jan PA-C 2806-10-003 PADA448 Vol License Suspension Suspended license pending outcome of current

investigation


3/9/2010 Okoh, James Ikemefuna MD MEDT4960 Application abandoned Application abandoned one year after temp permit

expired; no communication from applicant

Permanent license not issued; temp permit expired 3/9/2009

2/17/2010 Zajac, Richard J. MD 2800-07-005

2800-09-002

MEDS5847 Accusation Revocation of license in Kentucky

1/22/2010 Abbott, Jay Lewis MD 2800-07-019 MEDS4843 Decision and Order following hearing,

includes civil fine of $1,000 and

reprimand

Failure to report malp settlement as required None

1/22/2010 Fenger, Jesse Thomas PA-C 2806-09-005 PADA728 Board Order for medical and

psychological evaluations

Confidential Complaint None

1/22/2010 Thompson, Robert G. MD 2800-05-012

et.al.

MEDS2047 Consent agreement including civil fine

of $52,500 w/ $17,000 susp, 5-yr

prob, prohibition from advertising or

ethics training, CME in gynecology

practicing dermato.;

Professional incompetence, recording keeping

violations

Limitations as provided in agreement; because of amendment to

agreement, he did not agree to change until 3/3/10

1/22/2010 Zajac, Richard J. MD 2800-07-005

2800-09-002

MEDS5847 Suspension of License Petition for suspension of license granted based on

license revocation in Kentucky


1/22/2010 Nance, Jennifer Diane PA-C 2806-09-006 PADA858 Consent Agreement with civil fine of


Failure to provide copy of DEA registration to board

for board records

None

1/22/2010 Ilardi, Frank Joseph MD MEDS2446 Petition for restoration of surrendered

license denied

Based on license in ME being denied, NY lic was

revoked, and erased from register by UK and

cancelled by New Zealand


1/22/2010 Wilson, James Edward PA-C 2856-09-002 License application denied License in Maine remains surrendered; failure to

disclose problems during medical school education


Page 18 of 45






DATE OF


11/4/2009 Mickleson, Dennis Lynn MD 2800-05-024 MEDS2638 Consent Agreement with reprimand,

5-yr probation, practice restrictions

Based on drug diversion, substance abuse,

impairment, other state license revoked


10/23/2009 Avila, Emilio MD 2800-08-015 MEDS2360 Order terminating probation Restrictions no longer required

10/23/2009 Tomera, Kevin Marion MD 2800-07-024 MEDS2985 Board Order releasing him from

conditions of Memorandum of

Agreement from 01/24/08

Satisfied conditions of agreement None

10/26/2009 Melloh, James MD 2800-09-018 MEDS2960 Nondisciplinary Consent Agrmt Extension of time to obtain required CME for license

renewal

None

10/22/2009 Illig, Petra A. MD 2800-09-016 MEDS4183 Consent Agreement with civil fine of


Failed to renew license when it expired 12/31/08 and

continued to practice until 09/04/09

None

10/22/2009 Ramzan, Uzma Muhammad MD 2800-09-015 MEDT5328 Consent Agreement with civil fine of


LT Permit No. 5086 expired 07/28/09; contin to

practice until 08/25/09 without a valid license or

permit

None

10/22/2009 Zientek, Gary Michael MD 2850-09-005 MEDS6754 Consent Agreement that includes 5

yrs of probation monitoring for

chemical dependency

Alcohol impairment and substance abuse; DUI

conviction in FL; license suspension/revocation in VA


10/22/2009 Sullivan, Michelle A. MICP 2809-09-001 MEDM353 Nondisciplinary Consent Agrmt Five-yr probation, requirement for counseling/ therapy

with reports to bd, supervised practice


10/22/2009 Boston, John Cecil DO 2802-09-005 MEDO5285 Consent Agreement with civil fine of

$20,000 with $10,000 suspd,

probation for 1 yr, reprimand, random

pharmacy sweeps

Allowed staff members to sign his prescriptions

including controlled substances for him for period of 5

yrs

None

10/22/2009 Borden, James Brooks MD 2850-05-004 MEDS1176 Default Revocation of License Violated agreement to not practice mediciine in

Alaska; failure to provide truthful information in

renewal applications; failed to respond to accusation

filed against him; failed to respond to investigators


10/22/2009 Miller, Jo Anne PA-C 2807-09-001 PADA697 Consent Agreement with civil fine of


Failure to report outcome of malpractice settlement

as required by law

None

10/22/2009 Davidhizar, Lavern DO 2802-01-003;

2802-02-001;

2802-03-004;

2802-07-002;

2802-07-003

MEDO1454 Consent Agreement with civil fine of

$35,000, reprimand, re-education

requirements, CME, 5 yrs prob,

practice monitor, and reports to bd

Originally disciplined in 1999 w/ fine & probation for

failure to maintain medical records and for

prescriptive practice issues; continued to rec

complaints re overprescribing, failure to monitor

prescriptions and effects on patients, demonstr lack

of concern for patient safety & failure to adhere to

standard of care; failed to maintain prof boundaries

w/ patients


9/24/2009 ter Penning, Buckley J. MD Withdrew application Due to costs assoc w/ requested full board interview None

9/18/2009 Bolnick, Jay M. MD Withdrew application Issues with application None

9/14/2009 Thompson, Robert G. MD 2800-07-007, et

al.

MEDS2047 Amended Accusation Allegations of unprofessional conduct and

professional incompetence, gross negligence and

repeated negligent conduct in 19 counts

None

9/3/2009 Clarke, Chienhua MD Withdrew application Secured other employ; no longer needed lic None

7/24/2009 Borden, James Brooks MD 2800-05-004 MEDS1176 Accusation Violated agreement not to return to Alaska to practice

(agreed to in 2004); submitted renewal in Jan 2005 in

which he responded no to a question regarding past

investigations when in fact there had been past

investigations

Cannot practice in Alaska, lic expired 12/31/06

Page 19 of 45






DATE OF


7/16/2009 Morrison, Matthew J. MICP 2856-086-002 Decision following Hearing Boards 07/24/08 denial of application vacated.

Following a hearing, the ALJ found that the

application should have been considered abandoned

and not brought before the bd for consideration.

Denial to be reported as denial without prejudice.

No license issued

7/16/2009 Barnes, David L. DO 2802-09-003 MEDO5182 Consent Agreement with a civil fine of

$20,000, a reprimand, a one-year

probation

Allowed staff to sign prescriptions for him incl

Schedules III thru V controlled substances from Oct

2003 through Mar 2009

One year probation

7/16/2009 OBrien, Jay P. PA-C 2806-09-004 PADA795 Consent Agreement with a civil fine of


Practiced medicine from April 2 - 8, 2009 without a

valid collaborative plan in place

None

7/16/2009 Silkey, Jacqueline Sue MD 2800-07-012 MEDS6083 Probation terminated Alaska probation was concurrent with AZ probation;

AZ probation satisfied in April 2009; terminated AK

probation

None

7/16/2009 Mullick, Monalisa MD 2852-09-001 Consent Agreement with a civil fine of


Failure to disclose academic probation from Aug

1996 - Feb 19997

None

7/13/2009 Abbott, Jay Lewis MD 2800-07-019 MEDS4843 Accusation Failure to report the outcome of a malpr claim as

required by law

6/22/2009 Scholl, Lesley Marlin MD 2800-09-011 MEDS5862 Voluntary Surrender of License Surrendered lic based on summary suspension by

Indiana board for criminal charges filed in the

Northern District of Indiana , case No. 3:09MJ-4, 1

count of "knowingly transferred a Title 26 firearm, a

silencer… 1 count of used and cause another to use

a facility of interstate commerce with the intent that a

murder(s) be committed…"


5/8/2009 Tomera, Kevin Marion MD 2800-07-024 MEDS2985 Amended Memorandum of Agrmt Removed requirement for psychotherapy All other provisions of probation remain the same

4/16/2009 Avila, Emilio MD 2800-08-015 MEDS2360 Consent Agreement with practice

requirements & disc sanctions of civil

fine of $6,000 with $3,000 suspended

Practice restrictions & probation monitoring

indefinitely for personal health issues; disc sanctions

for incorrect responses to three questions in app for

Conditions apply, see agreement

4/16/2009 Leichty, Roberta MICP 2808-09-001 MEDM278 Consent Agreement with civil fine of

$1,000 with $750 susp; reprimand

Continued to work without proper sponsor phy on file

with bd; leniency by bd since licensee does not

actually see patients but works in educ

None

4/16/2009 Fenner, Michael Neil MD 2800-09-001 MEDS5616 Consent Agreement with civil fine of

$1,000 & reprimand

Failure to report malpr settlement as required by law None

4/16/2009 Gallagher, Lisbeth A. MD 2800-08-028 MEDS5459 Consent Agreement with civil fine of

$1,000 & reprimand


4/16/2009 Helzerman, Ralph F, Jr. MD 2800-08-029 MEDS4280 Consent Agreement with civil fine of

$1,000 & reprimand


4/16/2009 Impson, Karen Dyan DO 2802-09-002 MEDO4300 Consent Agreement with civil fine of

$1,000 & reprimand

Failed to renew lic & cont to prac; prac w/ expired

license from 01/01/09 - 02/05/09

None

4/16/2009 Masslofsky, Anthony Paul PA-C 2806-08-002 PADA735 Consent Agreement with civil fine of

$3,000 with $1,500 susp, reprimand

Administered & dispensed controlled subst without

valid DEA registration on file w/ bd

None

4/16/2009 Garcia-Llorens, Eric Luis MD 2800-09-010 MEDS6545 Consent Agreement with civil fine of

$1,000 & reprimand

Failed to disclose academic probation in med school

in application for license; license granted with disc

sanctions

None

4/16/2009 Maerki, Leslie Job PA-C 2806-09-001 PADA807 Consent Agreement w/ civil fine of


Practiced medicine without valid license None

Page 20 of 45






DATE OF


2/27/2009 Thompson, Robert G. MD 2800-07-007, et

al.

MEDS2047 Accusation Allegations of unprofessional conduct and

professional incompetence, gross negligence and

repeated negligent conduct in 12 counts

2/13/2009 Sizemore, Donald Eric DO 2850-09-001 MEDO6669 Consent Agreement with civil fine of

$1,000 & reprimand

Failed to disclose disciplinary action during med

school

1/30/2009 Emery, Scott MD 2801-05-003 MEDT3572 Decision and Order following hearing Board issued decision and order upholding previous

denial of license. Following a hearing, the bd found

that he had conducted an IME without a license; he

asserted he had no knowledge that conducting IMEs

without a medical license was prohibited; bd found

that this single instance of unprof cond would not

perm bar him from applying for a license in AK.

No license issued; temp permit expired 2/9/2006

1/30/2009 Mason, Bret Lloyd DO 2802-04-008 MEDS2688 Probation terminated Probation was terminated by bd Conditions removed; license is restored to unconditions status

1/29/2009 Sykes, William M. MD 2800-07-029 MEDS3538 Decision and Order following hearing

by ALJ; reprimand and civil fine of

$1,000

Board adopted proposed decision to offer

unrestricted license with sanctions. If applicant

declines, then license is denied. Following a hearing,

the ALJ found that applicant engaged in

unprofessional conduct by failing to disclose previous

states of license and an investigation in another state.

None

1/29/2009 Horswill-Woods, Loetta M. DO 2802-09-001 MEDO4740 Consent Agreement w/ Civil fine of

$1,000 with $500 suspended, and

reprimand

Practicing med without license from Jan 1-22, 2009 None

1/29/2009 Palmer, William M. MD 2800-08-020 MEDS1092 Consent Agreement with practice

restrictions

Privileges at hospital were restricted with limitations

imposed; probation for 3 yrs and reports to bd

Restrictions apply

1/29/2009 Pellicciaro, Marc D. MD 2800-09-004 MEDS4850 Voluntary Surrender of License Surrendered lic while under investigation for

practicing with a lapsed license


1/12/2009 Hartig, Glenn Stuart DO 2802-07-001 MEDO4523 Amended Memorandum of Agrmt Reduced number of random tests to 24 times/yr All other provisions of probation remain the same

1/12/2009 Gleason, Timothy A. DO 2802-03-007 MEDO2544 Amended Memorandum of

Agreement

Approved therapist in MT; reduced personal

physician visits to annually; approved personal

physician to be in MT

All other provisions of probation remain the same

12/23/2008 Janis, Burton MD 2800-08-025 MEDS1655 Nondisciplinary Consent Agrmt Extension of time to obtain required CME for license

renewal

None

12/12/2008 Frederick, Mark Douglas PA-C 2806-08-003 PADA559 Vol Suspension of License Allegations concerning substance abuse

10/24/2018 Tomera, Kevin Marion MD 2800-07-024 MEDS2985 Amended Memorandum of Agrmt Reduced psychiatric monitoring to bimonthly,

eliminated practice monitoring

Other conditions remain unchanged

10/24/2008 Winczura, John A. J. PA-C 2806-05-001 PADA441 Board Order with Disciplinary

Sanctions - susp of lic w/ susp

stayed, civil fine of $1,000, &

reprimand

Bd found violations of memorandum of agrmt dated

07/21/2005; unlicensed prac without collaborative

plan for approx 4 wks

Condition of MOA remain

10/23/2008 Deitle, James F. PA-C 2806-08-001 PADA664 Consent Agreement with Civil Fine of

$5,000 with $3,500 suspended and a

reprimand

Practiced without a valid collaborative plan on file with

the board

None

10/23/2008 Poulos, Evangelos George MD 2800-08-017 MEDS5644 Consent Agreement with Civil Fine of


Failure to report the settlement of a malpractice claim

within the time limits provided by law.

None

10/23/2008 Savit, Russ Mark MD 2800-08-018 MEDS5516 Consent Agreement with Civil Fine of




None

10/9/2008 Zaremba, Claudette Ann MD 2800-08-014 MEDS6245 License restored Restored license after 7/21/08 suspension; CO board

vacated their suspension

Page 21 of 45






DATE OF


10/2/2008 Garrity, Alyce Loretta MD 2800-08-022 MEDS5228 Suspension of License Voluntary susp of lic while under investigation Cannot practice in Alaska

10/2/2008 Garrity, Alyce Loretta MD 2800-08-022 MEDS5228 Board Order Requiring Examination Due to concern over ability to practice safely, bd

ordered mental and physical evaluations

9/3/2008 Jackman, Lawrence Stanley MD 2800-07-035 MEDS4688 Order to reisntate suspended protion

of fine

Failed to pay the fine required under 10/25/07 MOA

8/19/2008 Oppenheimer, Jeffrey H. MD None Application Withdrawn Upon advice of staff, applicant withdrew app pending

outcome of investigation in other state

7/24/2008 Kohler, Erik Peter MD 2800-05-056;

2800-07-037

MEDS5237 Decision and Order following hearing

by ALJ; reprimand and civil fine of

$2,500

Board adopted proposed decision by ALJ. Following

hearing, the ALJ found the Division proved by a

preponderance of evidence that Kohlers license

applications contained intentional misrepresentations;

that he engaged in unprof conduct by failing to

disclose material info to initially obtain and thereafter

renew his med lic and that he failed to submit reqd

med malpr rept to bd as required by law

None

7/24/2008 Morrison, Matthew J. PA-C License Application Denied Failed to comply request for additional information for

application; unprof conduct by failing to disclose

material information in app; failed to disclose past

disciplinary history during PA education program.


7/24/2008 Casey, Sean Owen MD 2800-08-007 MEDS5695 Consent Agreement including a civil

fine of $1,000 and a reprimand



None

7/24/2008 Gerlay, Gary Steven MD 2800-03-028;

2800-04-024,, et

al.

MEDS3610 Revised Decision and Order that

revokes medical license in Alaska

Board adopted ALJ proposed decision to revoke

license. Admin law judges decision that concluded

with: In light of the nature of the multitude of clearly

established serious violations and Dr. Gerlays refusal

to comply with a lawful order of the board, the board

should revoke Dr. Gerlays medical license.


7/21/2008 Zaremba, Claudette Ann MD 2800-08-014 MEDS6245 Suspension of License Violation of 12/10/07 MOA, Colorado board

suspension of license.


7/24/2008 Rieker, Tracie Jean PA-C 2806-07-001 PADA717 Consent Agreement w/ civil fine of

$3,000 w/ $1,500 suspd & reprimand

Practiced from 07-27-2006 to 12-13-2006 without a

valid collaborative plan in place

None

7/24/2008 Teissler, Hana MD 2800-08-013 MEDS2966 Consent Agreement with Civil Fine of

$3,500 & reprimand

Audited for CME compliance in 1999, unable to

produce CME & refused to accept disc sanction,

surrendered lic; petitioned to restore license in 2008

& agreed to disc sanctions for earlier CME violations


7/14/2008 Hill, Diane Ella PA-C 2807-08-002 PADA802 Nondisciplinary Consent Agreement Applicant advised board she had not worked as a PA

since completing her training; she was uncomfortable

with unsupervised or remote practice; bd agreed to

grant conditioned license requiring on-site supervision

for 1 yr; this is a nondisciplinary agreemetn.

Must work under on-site supervisionfor one year w/ reports to board

6/28/2008 Barrett, Amanda C. MD None Application Withdrawn Secured job in another state, no longer needed

Alaska license

No license issued

Page 22 of 45






DATE OF


4/25/2008 Tillman, William F. MD 2850-08-002 Application withdrawn while under


Failed to disclose licenses in 5 states; rather than

agree to disciplinary sanction, withdrew application


4/18/2008 Daggett, Roger Lynn MICP 2808-08-001 MEDM670 Voluntary Surrender of License Under investigation for allegations of falsified

application for license and substance abuse


4/3/2008 Creelman, Kevin MD 2800-08-005 MEDS1326 Consent Agreement with practice

restrictions

Suspended from emergency medicine-attending

privileges at Providence Kodiak Island Med Ctr;

consent agreement restricts him from all

comprehensive emerg med attending responsibilities

May only work in emergency room as back-up or as emerg assistance

if necessary and to treat his own patients in ER only if specifically

requested by patient

4/3/2008 Gleason, Timothy A. DO 2802-03-007 MEDO2544 Amended Memorandum of

Agreement

Current psychiatric disorder is affecting ability to

safely practice; will not provide medical services

w/out prior written consent from board; must

demonstrate to boards satisfaction that he is safe to

practice


4/3/2008 Sellner, Henry Ascher MD 2800-08-001 MEDS5736 Voluntary Surrender of License Under active investigation for allegations of prof

incomp, gross negligence, repeated negligent

conduct


4/3/2008 Sykes, William M. MD 2800-07-029 Denial of application for license Failure to disclose 11 states of licensure and an

investigation in another state; unprofessional conduct.

Cannot practice in AK - no license issued

3/28/2008 Kamson, Solomon MD 2800-06-011 MEDS5332 Memorandum of Agreement with Civil

Fine of $2,000

Action based on suspension of license in WA for

unprofessional conduct

Probation until WA license is restored without conditions, conditions for

practice, civil fine of $2000

3/18/2018 Haicken, Barry Neil MD 2800-08-003 Application withdrawn while under


Failed to disclose past investigations in another state;

rather than agree to disciplinary sanction, withdrew

application


3/12/2008 Hartje, James L. MD 2800-08-003 Application withdrawn while under


Failed to disclose past investigations in another state;

rather than agree to disciplinary sanction, withdrew

application


1/25/2008 Hanly, Andrew Joseph MD 2850-07-002 License Denied by Board Failed to disclose 11 states of licensure in app;

refused to negotiate voluntary settlement that would

have included disciplinary sanctions


1/24/2008 Tomera, Kevin Marion MD 2800-07-024 MEDS2985 Memorandum of Agreement As a result of board ordered evaluations, concerns

about ability to practice safely

Probation for 5 years, required counseling, supervised practice, and

practice monitor required

1/24/2008 Skala, Robert David DO 2800-07-034 MEDS4995 Memorandum of Agreement with

Reprimand and Civil fine of $3,500 w/

$1,000 suspended

Failure to disclose in renewal that he had not obtained

required CME; failure to obtain minimum CME for

renewal of license


1/24/2008 Skan, Paul Marcus MD 2800-04-057 MEDS3693 Memorandum of Agreement with

reprimand and civil fine of $1,000

Failure to report malpractice settlement as required

by law

None

1/8/2008 Torres, Angela M. MD 2800-07-032 MEDS5293 Accusation dismissed CME audit resolved/closed None

12/10/2007 Zaremba, Claudette Ann MD 2801-07-001 MEDS6245 Memorandum of Agreement with Civil

Fine of $4,000 and a reprimand

Failure to disclose material information in appl for

license in AK

None

10/31/2007 Kohler, Erik Peter MD 2800-05-056 MEDS5237 Amended Accusation Filed Failure to disclose past invesetigations in both initial

app for license and in renewal documents

10/30/2007 Nicpon, Gregory K. MD Application withdrawn Withdrew application for unspecified reasons No license issued

10/30/2007 Miller, Jeffrey s. MD Application withdrawn Withdrew application for unspecified reasons No license issued

Page 23 of 45






DATE OF


10/26/2007 Cole, Elisabeth- Anne Douce MD 2800-06-015 MEDS4133 License Revoked Judgment by Default for failure to respond to

accusation filed 05/14/07; accusation based on

convictions for financial institution fraud and credit

card fraud; unprofessional conduct.


10/25/2007 Killebrew, David S. MD 2800-99-007 MEDS2656 Amendment to MOA Reduced number of random tests to monthly; all

other provisions remain the same

10/25/2007 Beirne, Mark . MD 2800-06-009 Decision and Order following hearing

by ALJ

Bd adopted proposed decision upholding license

denial due to practicing medicine without a license

after he surrenedered his license.


10/25/2007 Schurig, Samuel H. DO 2802-07-005 MEDO1967 Memorandum of Agreement with

restrictions, supervision

Professional incompetence, gross negligence, and/or

repeated negligent conduct, failure to comply with a

board order, intentionally or negligently permitting the

performance of patient care by a person under the

respondents supervision that does not conform to

minimum professional standards, alleged sexual

misconduct, and professional misconduct

Bd approved return of license with MOA with 10 yrs probation,

psychotherapy requirements, prohibition against remote practice,

rquired supervised practice by a board-approved physician, restricted

prescriptive authority, rquired actively-licensed chaperone when

treating female pts, cannot supervise PAs. Bd approved Ray

Andreassen, DO, Lic No 2011, as supv phy upon rect of signed

acknowledgement that he understands and accepts the supervision

responsibilities

10/25/2007 Waller, Frederick Trowbridge MD 2800-07-018 MEDS6243 Nondisciplinary Memorandum of

Agreement

In application for license, respondent disclosed

personal health matters that require that he restrict

his practice to IMEs and office consultations

Practice limited to performing IMEs and office consultations

10/25/2007 Jackman, Lawrence Stanley MD 2800-07-035 MEDS4688 Memorandum of Agreement w/ Civil

fine of $3,500 w/ $2,150 suspended;

satisfy CME for current lic period;

reprimand; mandatory CME audit for

2 lic periods

Failure to disclose in renewal application that he had

failed to obtain the minimum number of CME hours

required for renewal of license

None

10/25/2007 Palmer, William Morris MD 2800-07-028 MEDS1092 Memorandum of Agreement w/ Civil


satisfy CME for current lic period;

reprimand; mandatory CME audit for

2 lic periods; suspension of lic til CME

documents produced

Failure to disclose in renewal application that he had

failed to obtain the minimum number of CME hours

required for renewal of license

None

10/17/2007 Rougeux, Richard Thomas MD 2800-07-031 MEDS6178 Nondisciplinary Memorandum of

Agreement

Due to personal health issues, will maintain an on-

going treatment relationship w/ personal physician

and remain in compliance with all tx

recommendations with reports to board; should he

move to AK, he will establish new patient/physician

relationship w/ AK physician.

Required to remain in treatment with semi-annual reports to bd

9/22/2007 Orquiza, Rene S. MD Application Withdrawn Withdrew application because of difficulty getting

license info from Phillipines; nondisciplinary

No license issued

9/12/2007 Tansky, Brian A. MD 2800-06-005 MEDS4511 Memorandum of Agreement w/ Civil

fine of $2,000 & reprimand

Inappropriate behavior, lack of professionalism in

workplace (horseplay)

None

9/4/2007 Torres, Angela M. MD 2800-07-032 MEDS5293 Accusation Failure to respond to CME audit None

7/19/2007 Jensen, Dag Andre MD 2803-07-001 MEDS3768 Memorandum of Agreement w/ Civil

Fine of $2,500 & reprimand

Failure to disclose past investigation and disciplinary

history in application

None

7/19/2007 Scherr, Daron Lynn MD 2850-07-003 MEDS6141 Memorandum of Agreement w/ Civil

Fine of $1,000 & reprimand

Failure to disclose past disciplinary action during

postgraduate training

None

Page 24 of 45






DATE OF


7/19/2007 Ash, Jamie PA-C 2806-07-003 PADA688 Memorandum of Agreement w/

$3,000 fine w/ $1,500 susp &

reprimand

Practiced medicine between 01/01/2007 and

03/13/2007 when license was lapsed.

None

7/19/2007 Walter, Jacqueline Wilhemina MD 2800-07-014 MEDS5125 Voluntary Surrender of License Surrendered license in lieu of possible disc Cannot practice in Alaska

7/19/2007 Okeke, Adaeze Christine MD 2800-07-021 MEDS6134 Memorandum of Agreement w/

$1,000 Civil Fine & Reprimand

Failure to disclose past disc action by med school None

7/19/2007 Glenn, James Leland PA-C 2806-06-002 PADA695 Memorandum of Agreement w/

$5,000 fine w/ $2,500 suspended &

reprimand

Prescribed Schedule II controlled substances without

legal authority and failed to maintain a copy of valid

DEA registration w/ board

None

7/19/2007 Hartig, Glenn Stuart DO 2802-07-001 MEDO4523 Memorandum of Agreement w/ 5-Yr

Probation w/ biological testing, AA,

Counseling

Alcohol abuse, reported to work while under influence

of alcohol

Probation requirements 5 yrs

7/19/2007 Boucek, Robert Joseph MD 2801-05-004 MEDS6039 Amended Memo of Agreement Amended agreement correctedlegal cites that were

erroneously listed in original memorandum of

agreement dated April 12, 2007

None

6/25/2007 Tomera, Kevin Marion MD 2800-07-024 MEDS2985 Board Order Requiring Examination Due to concerns over his ability to continue to

practice medicine safely, the board has ordered a

complete psychiatric and medical exam.

Must complete examination within 45 days

6/11/2007 Vij, Vikas MD Application Withdrawn Applicant withdrew license application when

employment offer fell through

License not issued

6/1/2007 Kohler, Erik Peter MD 2800-05-056 MEDS5237 Accusation Filed Failure to disclose past invesetigations in both initial

app for license and in renewal documents

5/26/2007 Murphy, Colleen MD 2800-05-026 MEDS3162 End of License Probation Complied with terms of 7/14/06 MOA None

5/23/2007 Mondal, Kamalendra Nath MD Application Withdrawn Applicant withdrew license application no reason

given

License not issued

5/14/2007 Cole, Elisabeth- Anne Douce MD 2800-06-015 MEDS4133 Accusation Filed Convictions for financial institution fraud and credit

card fraud; unprofessional conduct

4/12/2007 Robinson, David Benjamin MD 2800-07-006 MEDS3240 Memorandum of Agreement w/ civil


Failed to renew license and practiced medicine with

expired license from 1/1/07 to 1/12/07

None

4/12/2007 Stiles, Wendy Laura MD 2852-05-002 MEDS6040 Memorandum of Agreement w/ civil


Failed to disclose disciplinary action during

postgraduate training

None

4/12/2007 Ferguson, James Thompson PA-C 2807-07-001 PADA310 Memorandum of Agreement w/ civil

fine of $1,000 with $500 suspended,

and reprimand



None

4/12/2007 Sirois, Cindy H. Nguyen MD 2800-07-011 MEDS6082 Memorandum of Agreement w/ civil


Failure to disclose past investigation history in

another state in application for AK license

None

4/12/2007 Silkey, Jacqueline Sue MD 2800-07-012 MEDS6083 Memorandum of Agreement w/

Probation of Five Years including

monitoring and testing

Applicant disclosed past chemical dependency and

drug diversion issues in another state in her

application for AK license; in voluntary monitoring

program in other state

Probation for five years including monitoring and testing; other

conditions apply

4/12/2007 Youngberg, Rush Alexander MD 2850-06-007 MEDS6041 Memorandum of Agreement w/ civil


Failure to disclose past investigation history in

another state in application for AK license

None

4/12/2007 Buchanan, Richard F. MD 2800-06-010 MEDS1103 Voluntary Surrender of License Due to personal health reasons, voluntarily

surrendered license


4/12/2007 Fortson, Jayne Schiff MD 2800-07-003 MEDS2600 Memorandum of Agreement w/ civil




None

4/12/2007 Boucek, Robert Joseph MD 2801-05-004 MEDS6039 Memorandum of Agreement w/ civil


Practiced medicine for six days without a license None

Page 25 of 45






DATE OF


3/15/2007 Schoonover, Daniel Kem MD 2800-04-006 MEDS2350 Board Order Requiring Examination Due to concerns over his ability to continue to

practice medicine safely, the board has ordered a

complete psychiatric and medical exam.

Must complete examination within 60 days

3/15/2007 Hartig, Glenn Stuart MD 2802-07-001 MEDS4523 Vol Suspension of License Employment suspended for chem dep issues at

ANMC; vol entered treatment program; vol susp

license

Cannot practice in AK - suspended license

2/22/2007 Engelbach, Ludmilla M. MD Application Withdrawn Application withdrawn due to personal health issues No license issued

1/26/2007 Chicola, Cathryn Lynn MD 2800-07-001 MEDS4781 Memorandum of Agreement with

Reprimand and Civil Fine of $1,000

Violated law regarding reporting requirement of

malpractice settlements within 30 days of date of

settlement.

None

1/25/2007 Gano, Roger G. MD 2800-05-074 MEDS4138 Decision and Order following hearing

by ALJ

Board adopted ALJ proposed decision upholding

denial of petition for license reinstatement. Following

a hearing, the ALJ decision stated he had not met

burden of proving he can practice medicine with

reasonable skill and safety.


1/25/2007 Nicholas, Winslow C. MD 2800-06-012 MEDS3110 Voluntary Surrender of License Surrendered while under active investigation for

allegations regarding his license surrender in

Pennsylvania for having an addictive disease


1/25/2007 Garreaud, Hernan J. PA-C 2806-03-002 PADA556 Memorandum of Agreement with


Violated Phys Asst prescribing law by issuing a

prescription for a Schedule II controlled substance

None

1/25/2007 Kamson, Solomon MD 2800-06-011 MEDS5332 Voluntary Suspension of License Suspended license due to allegations of

incompetence, negligence or malpractice by WA

Board

Cannot practice in AK until such time as he proves to board he is safe

to resume practice

1/25/2007 Foody, William James MD 2800-06-014 MEDS3195 Voluntary Surrender of License Surrendered while under active investigation for

allegations of negligence


1/25/2007 Wald, Robert David MD 2800-07-004 MEDS3171 Memorandum of Agreement with


suspended for self-disclosure

Continued to practice after license had expired,

renewed late on 01/16/07.

None. Board noted appreciation for self-disclosure

1/25/2007 Reynolds, David W. M 2858-05-001 Decision and Order following hearing

by ALJ

Board adopted ALJ proposed decision upholding

denial of application for license. Following a hearing,

the ALJ found that the applicant was disqualified from

licensure and the denial was reasonable based on

past actions.


1/25/2007 Bernzott, Michael R. MD 2800-95-019, et

al.

MEDS3099 Board Order Modifying MOA Removed restriction from using firearms in patient

treatment.

None

1/25/2007 Winczura, John A. J. PA-C 2806-05-001 PADA441 Board Order Modifying MOA Board revised MOA to reduce number of drug tests

to 1/month; changed drug test to Etg test; 12 hrs in

which to response to random test; reduced required

AA meetings to 2/wk.

Conditions in MOA remain with modifications cited

1/25/2007 Emery, Scott MD 2801-05-003 MEDT3572 License Application Denied Denied application for alleged violations of laws

prohibiting practicing medicine without a license

Cannot practice in AK; was previously licensed in AK temp permit #T-

3572 expired 2/9/06, license #S-1640 lapsed 12/31/94

1/25/2007 Plunkett, Patrick Aaron MD License Denied by Board Application denied due to criminal and/or license

action in California.


1/19/2007 Trevino, Rodolfo N. MD Application Withdrawn Withdrew application for personal reasons No license issued

Page 26 of 45






DATE OF


11/17/2006 Lovett, Dennis A. MICP 2808-06-001 MEDM90 Voluntary Surrender of License Surrendered for failure to meet CME reqrmts for

renewal, false response re CME question in renewal


10/13/2006 Zajac, Richard John MD 2800-06-007 MEDS5847 Memorandum of Agreement w/ Civil

fine of $1,000 and Reprimand

Failed to disclose past investigation in KY in

application for license

None

10/13/2006 Ilardi, Frank Joseph MD 2800-03-039;

2800-04-023

MEDS2446 Voluntary Surrender of License Surrendered while in hearing for sexual misconduct,

unprofessional conduct in connection w/ delivery of

professional services and presc controlled

substances without evaluation, exam, diagnosis, or


10/13/2006 Borman, Timothy Richard MD 2852-06-001 MEDO5944 Nondisciplinary Memorandum of

Agreement to voluntarily restrict

practice

Nondisciplinary Disclosed personal health issues in

app; voluntarily agreed to MOA to restrict practice to

IMEs; no disciplinary sanctions

Practice restricted to IMEs

10/13/2006 Sorensen, Kurt E. MICP 2808-04-001 MEDM147 License Revoked Board did not adopt ALJs decision following hearing

and voted to revoke license for criminal conviction &

mishandling of controlled substances.

Cannot practice in AK - Board may consider restoring license if criminal

conviction set aside

10/13/2006 Schurig, Samuel H. DO Petition for Reinstatement of License

Denied

Bd had not found that he is safe to return to practice Cannot practice in Alaska

10/12/2006 Masslofsky, Anthony Paul PA-C Memorandum of Agreement with 2-yr

probation

Disclosed treatment for depression, probation

requires monitoring when practicing in AK

Two-yr probation w/ reporting to board

10/12/2006 Pae, Aeri MD 2850-06-004 3982 Memorandum of Agreement w/ Civil

Fine of $1,000 & Reprimand

Failed to disclose 2 past investigations by FL Bd and

letter of caution issued by that board

None

10/12/2006 Diamante, Paula Anne MD 2850-06-006 MEDS5908 Memorandum of Agreement w/ Civil

Fine of $1,000 and Reprimand

Failure to disclose probation during medical school

education in application

None

7/20/2006 Strobbe, Steven Maurice DO 2852-05-001 MEDO5725 Memorandum of Agreement language

slightly modified

Legal cites as reasons for the MOA were changed to

more accurately reflect reason for MOA w/

disciplinary sanctions

None

7/20/2006 Beirne, Mark . MD License application denied Bd cited past felony conviction, alcohol addiction, lic

surrendered under active investigatin, unprof conduct

(related to assault conviction), pract med without a

license


7/20/2006 Van Houten, Jay D. DO License application denied Applic for license denied because he agreed to never

seek license in AK again when he surrendered his

license in 2004; did not appeal summary suspension

in 2002; engaged in fraud; prof incomptetence, gross

negl, or repeated negl conduct; vioalated code of

ethics; prof incompet; no demonsration to bd that he

is now competent


7/14/2006 Murphy, Colleen Mary E. MD 2800-05-026 MEDS3162 Memorandum of Agreement with 1-

yr probation

Voluntary settlement to resolve accusation without

admission of wrongdoing re: allegations of

professional incompetence that included suspension

and reinstatement of privileges from Providence

Alaska Med Ctr

One-yr probation that includes compliance w/ PAMCs requirements

detailed in letter of 5/26/06; periodic interviews w/ board; probation

retro to 5/26/06, ends 5/26/07

4/24/2006 McCallum, Thomas Lee MD 2850-06-001 MEDS5804 Memorandum of Agreement w/ Civil

Fine of $2,000 & Reprimand

Failure to disclose four states of licensure in

application

None

4/6/2006 Hussain, Faiz Muhammed MD 2850-06-002 MEDS5768 Memorandum of Agreement w/ Civil

Fine of $1,000 and Reprimand

Failure to disclose probation during residency training

in application

None

Page 27 of 45






DATE OF


3/10/2006 Murphy, Colleen M. MD 2800-05-026 MEDS3162 Second Amended Accusation Additional counts added for new cases

1/24/2006 Ilardi, Frank Joseph MD 2800-03-039,

2800-04-023

MEDS2446 Accusation Allegations of sexual misconduct, ethics violations

1/12/2006 Strobbe, Steven Maurice DO 2852-05-001 MEDO5725 Memorandum of Agreement w/ civil

fine of $1,000 and reprimand

Failure to disclose past investigation License granted with sanctions in MOA

1/12/2006 Donaldson, Brian R. MD 2800-01-086, et

al.

MEDS1948 Memorandum of Agreement w/

restrictions

Inappropriate behavior w/ female pts; hypomanic

behavior irregular thought patterns

Therapy required; female chaperone required w/ female pts; surrender

DEA registration; practice monitoring

1/12/2006 Muir, Colin MD 2850-04-006 Decision and Order following hearing

by ALJ of denial of application

Muir appealed boards denial of license app; hearing

held and ALJ upheld boards decision to deny


11/22/2005 Stewart, George Louis MD 2800-05-072 MEDS926 Voluntary Surrender of License Surrendered while under active investigation for

allegations of sexual misconduct & substance

dependence


10/21/2005 Killebrew, David S. MD 2800-99-007 MEDS2656 License suspension 180 days w/ 120

suspended; civil fine of $6,000 w/ all

suspended; reqrd EtG tests weekly to

be monitored by Div staff; monitoring

by PHC; prob for 8 yrs when susp

ends; perm total abstinence;

additional conditions apply

Board Decision on Remand from Appeal to Superior

Court

License supended 12/9/05, ends midnight 2/7/06; probation for 8 yrs

commencing 2/8/06 with conditions

10/21/2005 Murphy, Colleen M. MD 2800-05-026 MEDS3162 License Reinstated Board adopted ALJs Proposed Decision after

hearing, to vacate the order of summary suspension

and reinstate license

License restored to active status

10/21/2005 Kohchet Chua, Claribel

(aka Claribel Tan)

MD 2850-05-006 MEDS5689 Memorandum of Agreement w/ civil


Failure to disclose in application two probation actions

taken by residency program for tardiness and

marginal performance

License granted with sanctions in MOA

10/21/2005 Garfield, David Harold MD 2800-05-075 MEDS5708 Memorandum of Agreement w/ civil

fine of $500 and reprimand

Failure to list all states of licensure in application

(failed to list 3 states)

License granted with sanctions in MOA

10/21/2005 Ok, Tae Duk PA-C 2806-03-007 PADA541 Suspension of License Ended Lic suspended for one year 10/21/2004 None - license restored to active status

10/20/2005 Nordby, Arthur LeRoy MD 2800-05-055 MEDS568 Voluntary Surrender of License Surrendered license while under audit for CME;

unable to comply w/ CME reqrmts for lic renwl


10/20/2005 Koller, John Michael MD 2800-03-040 MEDS3737 Memorandum of Agreement with civil

fine of $10,000 w/ $5,000 stayed,

reprimand

Practiced medicine from 05/31 to 07/25/03 without a

license

None

8/11/2005 Coon, Duane A. MD 2800-05-009;

2800-05-34

MEDS368 Voluntary Surrender of License Inappropriate prescribing of controlled substance

meds; standard of care allegation related to patients

who have died


8/11/2005 Gills, Raymond E. MD 2800-05-061 MEDS824 Nondisciplinary Memorandum of

agreement

Practice restricted to OB/GYN; failed to pass all

portions of SPEX exam when returning lic to active

from retired status

Practice restricted to OB/GYN THIS

IS NOT A DISCIPLINARY ACTION

8/10/2005 Gerlay, Gary Steven MD 2800-03-028;

2800-04-024, et

al.

MEDS3610 Board adopted ALJs Decision

upholding summary suspension

Respondent appealed boards summary suspension

action in a hearing; admin law judge found the

suspension justified based on sexual misconduct

alone, failure to meet standard of care alone or

concerns about impairment alone

Cannot practice in AK - license remains suspended

8/10/2005 Adams, Ralph Edwin MD 2800-05-060 MEDS3476 Voluntary Suspension Based on investigation into his suspended license in

Oregon


Page 28 of 45






DATE OF


8/9/2005 Sorensen, Kurt E. MICP 2808-04-001 MEDM147 Accusation filed Based on conviction of 4th Deg miscond involving a

controlled substance, a Class C felony

Not authorized to practice ; no physician sponsor

7/22/2005 Virella, Anthony A. MD License Application Denied Denied for failure to compy w/ bds reqst for full bd

intervu to answer qs re residency trng, discipl by resid

prgm, & failur to discl in app


7/22/2005 Vinueza, Tirso MD License Application Denied Application denied for failure to comply w/ request of

bd for full bd interview to respond to qs re hosp verifs


7/22/2005 Fitzpatrick, Nancy Jo. PA-C 2856-04-002 PADA646 Memorandum of agreement

terminated

Bd approved release from terms of MOA Conditions of license removed

7/22/2005 Murphy, Colleen M. MD 2800-05-026 MEDS3162 Amended accusation Filed Additional counts entered

7/21/2005 Biglow, John R. MD 2800-05-029 MEDS3967 Memorandum of Agreement w/ civil

fine of $3,500; reprimand

Failure to meet CME requirements; failed to disclose

in renewal


7/21/2005 Brudenell, Ross N. MD 2800-04-055 MEDS1664 Memorandum of Agreement w/ civil


reprimand

Prescribed Schedule II controlled substance meds

after reports from occ/phy therapists but w/out direct

pt contact

None

7/21/2005 Dietz, Susan K. MD 2800-05-027 MEDS4272 Memorandum of Agreement w/ civil


reprimand CME requirements include

mandatory audit for next 2 license

periods


in renewal

None

7/21/2005 McCorkle, Matthew S. MICP 2809-05-001 MEDM544 Memorandum of Agreement w/ civil

file of $5,000; reprimand

Practiced as a Paramedic w/o a valid licence;

provided Schedule II controlled substance to patient

7/21/2005 Ning, John Tse-Tso MD 2800-03-042 MEDS4258 Agreement Not to Renew License; Based on vol surrender of LA lic; amended

accusation filed in 11-2004 in AK

Not authorized to practice in Alaska

7/21/2005 Wasile, Olga I. MD 2800-05-030 MEDS4987 Memorandum of Agreement w/ civil


reprimand


in renewal


7/21/2005 Winczura, John A. PA-C 2806-05-001 PADA441 Memorandum of Agreement w/ fine of

$3,000 suspended; probation w/

restrictions; reinstatement of license

Lic susp in 01-2004; lic approved for reinstatemt

subject to MOA but licensee refused; Signed MOA in

Apr 2005; bd approved July 2005

Practice conditions and restrictions apply

7/14/2005 Murphy, Colleen M. MD 2800-05-026 MEDS3162 Accusation Filed Alleged professional incompetence, negligence or

repeated negligent conduct

7/7/2005 Murphy, Colleen M. MD 2800-05-026 MEDS3162 Summary Suspension of License Alleged failure to meet minimum professional

standards of care in five of ten cases reviewed.

License supended, pending hearing

5/3/2005 Cole, Elisabeth-Anne Douce MD 2800-01-75 MEDS4133 Memorandum of Agreement with

License Suspension when released

from federal prison

Federal felony conviction of 5 counts of financial

institution fraud, 1 count of credit card fraud

Cannot return to practice until she complies with all licensing

requirements, and is physically/mentall/professionally capable of

performing duties of physician; must comply with other requirementsas

board deems appropriate

5/3/2005 Palmer, Martin MD 2800-03-005 MEDS756 Voluntary Surrender of License 11/04 felony conviction for attempted 3rd degree

misconduct involving a controlled substance and

violation of 08/2003 MOA


5/3/2005 Vent, Sonia M. PA-C 2806-01-003 PADA166 Probationary period completed Violated prev prob/MOA, prac w/o collab plan No longer under restrictions; probation completed; initially placed on

probation 8/20/01

4/21/2005 Gerlay, Steven G. MD 2800-03-028;

2800-04-024, et

al.

MEDS3610 Summary Suspension Failed to meet minimum standards for controlled

substance prescribing; sex w/ pts; sexual

improprieties w/ other pts


Page 29 of 45






DATE OF


4/21/2005 Lang, Thomas G. MD 2800-05-014 MEDS1579 Memorandum of Agreement with civil

fine of $30,000; reprimand

Practiced medicine with a lapsed license from 12-31-

02 to 03-02-05; prescribed controlled substances,

failed to meet CME reqrmts

4/21/2005 Marquardt, Ashley F. PA-C 2806-05-002 PADA534 Memorandum of Agreement with civil


reprimand

Prescribed controlled substances with an expired

DEA registration

None

4/21/2005 May, April A. PA-C 2806-04-004 PADA587 Voluntary agreement to not renew

physician assistant license

Closure of investigation and release from all

provisions of the Memorandum of Agreement dated

April 3, 2003


4/21/2005 Wise, Larry K. MD 2800-05-008 MEDS4706 Memorandum of Agreement with civil


Failure to disclose in initial application in 2001 that he

had been suspended from med school from Dec

1988 to July 1989

4/21/2005 Yost, Ann-Marie MD 2850-05-003 MEDS3382 Memorandum of Agreement with civil


Failure to disclose investigation in other state in initial

application for perm license in AK

4/21/2005 Boespflug, Randy MD 2850-04-005 License Application Denied Denial based on lic action in another state Cannot practice in AK - no license issued

4/21/2005 Schonbrun, Paul J. MD License Application Denied Denial based on unprof conduct allegations from

residency training, action by NY board; perm

suspension by PA of that trainee license


4/21/2005 Reynolds, David W. MICP License Application Denied Denial based on alleged violations of unprof conduct;

lic in ME under active investigation; theft of govt prop;

alleged violations of codes of conduct for

paramedics; failure to disclose in app issues related

to above matters


4/21/2005 Gano, Roger G. MD 2800-03-023;

2800-01-066

MEDS4138 Denial of request to modify terms of

MOA

Bd denied request to make modifications to the terms

of the Jan 2005 MOA that would lessen some of bd-

imposed restrictions

Cannot practice in AK; license has not been restored and remains in

suspended status

4/7/2005 Mickleson, Dennis L. MD 2800-05-024 MEDS2638 Voluntary suspension of license Allegation of substance abuse and questions

concerning physical and mental health


4/1/2005 Routh, Lisa C. MD 2800-99-120 MEDS3470 Memorandum of Agreement w/ civil

fine of $10,000, may not apply for

reinstatement of lapsed license or

apply for any physician license

Allegations of inappropriate prescribing; employed a

patient, standard of care concerns, record keeping

violations


4/1/2005 Donaldson, Brian R. MD 2800-01-086;

2800-03-66, et

al.

MEDS1948 Board Order Board ordered psychiatric/psychological and medical

evaluation

1/20/2005 Bernzott, Michael R. MD 2800-95-019 et

al.

MEDS3099 Memorandum of Agreement including

civil fine of $10,000 w/ $4,000

suspended and reprimand

Significant errors in clinical judgement by giving a pt a

handgun during tx; failed to provide copy of med

records when reqstd; attempted to obtain a license

thru deceit, fraud, or intentional misrep in another

state

Cannot use a firearm in connection with his treatment of patients

1/20/2005 Finlay, Robert W. PA-C 2806-03-003 PADA545 Memorandum of Agreement w/ civil


reprimand

Practiced medicine without valid collab plan and

permit for the practice on two separate occasions

None

1/20/2005 Winczura, John A. J. PA-C 2806-00-1 PADA441 Petition to reinstate suspended

license gratned with Memorandum of

Agreemetn w/ conditions

License may be restored under conditions of an

executed MOA that contains hearing officers

recommendations adopted 01/16/04; number of work

hrs chgd to 48 hrs/wk

May return to practice with conditions upon full execution of MOA

Page 30 of 45






DATE OF


1/20/2005 Gano, Roger G. MD 2800-03-023;

2800-01-066

MEDS4138 Petition to reinstate suspended

license granted with Memorandum of

Agreement w/ conditions

License may be restored under conditions of an

executed MOA that contains substance abuse

provisions, practice supervision, required chart

review by supv psychiatrist, reports to board, and

weekly psychotherapy sessions

May return to practice with conditions upon full execution of MOA

12/23/2004 Schurig, Samuel H. DO 2802-03-009 MEDO1967 Amended MOA; extends current

license suspension for 2 more years

Voluntary settlement of accusation filed 11/07/02 Cannot practice in AK for at least coming 2 yrs

11/16/2004 Ning, John Tse-Tso MD 2800-03-042 MEDS4258 Amended Accusation Filed Voluntary Surrender of LA license

10/21/2004 Cole, Elisabeth-Anne MD 2800-01-075 MEDS4133 Board Order Board ordered psychiatric/psychological and medical

evaluation

10/21/2004 Van Houten, Jay David DO 2802-99-005 et

al.

MEDO2780 Voluntary Surrender In lieu of revocation or other licensing action;

allegations of incompetence & unprofessional

conduct


10/21/2004 Ok, Tae Duk PA-C 2806-03-007 PADA541 Memorandum of Agreement w/ 1-yr

license suspension, civil file of

$10,000 w/ $5,000 suspd;

relinquishment of DEA regis;

reprimand

Licensee wrongfully sold controlled substance

medications including Demerol and Morphine to a

person who he had previously prescribed pain meds

for; pled No Contest to a misdemean charge of

misapplication of property & sentenced to 30 days in

jail & probation for 6 mos.

Cannot practice for one year

10/21/2004 Pister, James D. MD 2800-01-028 MEDS1493 Memorandum of Agreement w/ civil


Practiced without a valid license Jan 1 - 23, 2001

10/21/2004 Petro, Winnona Gay PA-C 2806-02-009 PADA306 Memorandum of Agreement w/ civil


reprimand

Licensee wrongfully issued prescriptions for Sched II

controlled subst meds; illegal fo Pas to issue scrpts

for Sched II in Alaska

10/21/2004 Mason, Bret Lloyd DO 2802-04-008 MEDS2688 Memorandum of Agreement w/ 6-mo

license suspension, civil fine of

$10,000 w/ $5,000 stayed, lic

suspension stayed

Convicted of Assault in Fourth Degree and Resisting

or Interfering with Arrest; alcohol dependence

Must practice under terms of 04/02/04 Memorandum of Agreement

10/21/2004 Bernzott, Michael Roy MD 2800-95-019 et

al.

MEDS3099 Revocation by Default Judgement Bd held default proceeding based on accusation filed

06-02-2004, eff. 11/25/04


08/03/2004 Fitzpatrick, Nancy Jo PA-C 2856-04-2 PADA646 Memorandum of Agreement w/

monitoring & 5 yr prob due to

personal health issues

Disclosed personal health matter in app for lic Probation for 5 yrs; monitoring; required tx; require reports to board

7/16/2004 Bedder, Helen F. MD 2850-01-011 License Application Denied Declined to enter into Memorandum of Agreemt Cannot practice in AK - no license issued

7/15/2004 Muir, Colin MD 2850-04-006 License Application Denied Failure to report complaints/investigations in another

state; alleged failure to report problem at hosp

resulting in resignation under investig.


07/15/2004 Fox, Robert Scott MD 2800-03-012;

2800-03-032

MEDS3462 License Surrendered License voluntarily surrendered while under

investigation for inappro prescribing of contrl

substances, substandard medical care


7/15/2004 Frankum, Wilbur Max MD 2850-04-002 MEDS5378 Memorandum of Agreement w/ civil


Failure to disclose past investigation in TX in

application for license

None

7/15/2004 Beltran, Javier MD License Application Denied Failure to meet threshold requirements for lic Cannot practice in AK - no license issued

7/15/2004 Palmer, Martin MD 2800-03-005 MEDS756 Petition denied to lessen fiine Bd declined to reduce civil fine imposed in 2003

Page 31 of 45






DATE OF


7/7/2004 Schurig, Samuel H. DO 2802-03-009 MEDO1967 Accusation filed Based on felony conviction of HUD fraud in

U.S.District Court

6/9/2004 Gleason, Timothy A. DO 2802-03-7 MEDO2544 Memorandum of Agreement with

probation & treatment rquiremts

Following self-disclosure & a complaint filed,

underwent eval; personal health matter diagnosed

Five-yr probation with reporting requirements, treatment requirements,

prohibition from consuming meds without proper prescription;

prohibition from self-med, self-evaluation to bd, periodic interview w/ bd

6/9/2004 Howlett, Kami Rae PA-C 2806-04-002 PADA596 Memorandum of Agreement with civil

fine of $1,000, reprimand

Prescribed schedule II controlled substances

unlawfully

None

6/9/2004 Wonchala, David Paul PA-C 2806-04-003 PADA605 Memorandum of Agreement with civil


Prescribed schedule II controlled substances

unlawfully

None

6/2/2004 Bernzott, Michael Roy MD 2800-95-19;

2800-01-81;

2800-03-43

MEDS3099 Accusation Allegation of prof incompetence, gross negligence, or

repeated negligent conduct for providing a loaded

gun to a psychiatric pt; failure to provide requested

medical records; unprofessional conduct for providing

a false response to an application question in another

state

5/10/2004 Schilperoort, Steven John MD 2850-04-001 MEDS5305 Nondisciplinary Memorandum of

Agreement

Voluntary restrictions to medical practice due to

personal health matters

Practice limited to performing IMEs only

4/12/2004 Koller, John M. MD 2800-03-040 MEDS3737 Accusation Filed Practicing with an expired license

4/2/2004 Gano, Roger G. MD 2800-03-023;

2800-01-066

MEDS4138 Board Order Order for med/psych eval

4/2/2004 Mason, Bret Lloyd DO 2802-04-001 MEDO2688 Memorandum of Agreement w/ 5-yr

probation & practice restric.

Arrested & charged w/ DWI, altercation w/ cab driver

while intoxicated; alcohol dependence

Five yrs probation, random drug/alcohol screens, not practice more

than 50 h rs/7 days, cannot self-prescribe any meds or consume any

alcohol or drugs, periodic assessment, rehab counseling,

psychotherapy counseling, reports to bd from all tx providers

4/2/2004 Cole, Elisabeth-Anne Douce MD 2800-01-75 MEDS4133 Board Order for Med & Psych Eval To assist board in determining if licensee is able to

safely practice medicine in AK

Failure to comply with the order will result in automatic suspension of

license

4/1/2004 Price, James Harold, Jr. DO 2802-03-013 MEDO4221 Memorandum of Agreement; civil fine

of $5,000 w/ $2,000 susp, reprimand

Falsified a report he sent to patients employer stating

that he had examined the pt when he had not

If no further violations for one year, suspended portion of fine will be

vacated; no practice restrictions

4/1/2004 Brown, Carl Lester, Jr. PA-C 2806-02-003 PADA473 Memorandum of Agreement; civil fine

of $2,500; reprimand

Used pre-signed script forms to prescribe a Schedule

II drug

None

4/1/2004 Hanson, Donna Jean PA-C 2806-02-002 PADA406 Memorandum of Agreement; civil fine



II drug

None

4/1/2004 Oxford, Jennifer Jan PA-C 2806-02-004 PADA448 Memorandum of Agreement; civil fine



II drug

None

4/1/2004 Lamore, Van Eric PA-C 2856-04-001 PADA631 Memorandum of Agreement; civil fine


Failed to disclose disciplinary action in medical

training program

None

4/1/2004 Dente, Joseph Biagio MD 2850-02-001 MEDS4938 License Probation Terminated Board released him from conditions of license

probation adopted on 08/13/2002

None

4/1/2004 Makim, Jayesh D. MD 2850-01-008 MEDS3215 License Probation Terminated Board released Makim from conditions of license

probation adopted on 05/25/2001

None

4/1/2004 Jones, Miles J. MD 2800-02-18 MEDS4586 Adopted Hearing Officers Decision to

Revoke License

License revoked due to licenses revoked or

suspended in other states; (WI, ND, VA, MO, NY, AL,

KS); failure to disclose investigations/actions on

renewal application

Cannot practice in Aalska

4/1/2004 Bullock, Clarence PA-C 2806-02-08 PADA375 Denial of Petition to Restore License Petition to restore license denied by board based on

sexual miscndct, unprof conduct issues


Page 32 of 45






DATE OF


3/24/2004 Van Houten, Jay David DO See file for

compl list of

invest case

numbers

MEDO2780 Amended Accusation Filed Allegations of prof incompetence, gross negl,

repeated negl; inappr presc; failure to maintain proper

records; ethics violations; fraud, & criminal conviction

1/16/2004 Gottlieb, Jeffrey MD 2800-00-018 MEDS3119 Revocation of License Board adopted HO decision; also based on lics

convictions on 234 criminal counts re fraud in med

pract; false statements on initial lic app; felony theft;

unlawfully procuring, selling, prescribing and/or

dispensing drugs


1/16/2004 Winczura, John A. J. PA-C 2806-00-1 PADA441 License suspended 1 yr; civil fine

$3,000 all suspended pending no

future violations

Board adopted HO decision re violations incl worked

under influence, habitual overuse of alcohol, using

alcohol to extent it interferes w/ prof prac functions or

endangers safety of pts, prof incomp

Cannot practice in AK for 1 yr; when license is restored, prac

restrictions will apply including no more than 40 hr/wk, use numbered

presc pads, no remote location prac, prac only w/ on-site physician

supervision

1/15/2004 Blake, Richard W. PA-C 2807-03-001 PADA482 Memorandum of Agreement; civil fine

of $1,000, reprimand

Practiced w/o active collab plan in place None

1/15/2004 Herold, William L. MD 2800-02-9 MEDS4245 Memorandum of Agreement; civil fine


Prescribed controlled meds over Internet w/o

maintaining obtaining or proper records

None

1/15/2004 Blair, Gordon T. MD 2800-03-033 MEDS3015 Memorandum of Agreement; civil fine

$2,000, reprimand

Failure to meet CME requirements for licensure;

failure to disclose in renewal

None

1/15/2004 Kaniadakis, Steven J. DPM 2804-99-5127 MEDP2981 Revocation of License Board adopted HO decision; also based on lics

convictions on 16 counts health care fraud & 42

counts mail fraud, in federal court


12/12/2003 Worrell, Paul Martin MD 2800-03-052 MEDS908 Accusation Filed Alleged failure to comply w/ CME rqts of law

12/2/2003 Routh, Lisa Carole MD 2800-99-120 MEDS3470 Accusation Filed Allegations of inapprop prescrib; employed a pt;

standard of care concerns; record keeping violations

10/24/2003 Gray, Teresa K. MICP 2809-03-001 MEDM479 Memorandum of Agreement; civil fine

of $5,000 w/ $2,000 suspd; reprimand

Worked as MICP without a license None

10/24/2003 Khabir, Jeffrey A. MD 2800-02-060 MEDS3557 Memorandum of Agreement; civil fine



by law

None

10/23/2003 Rittger, Kevin Duane MD 2800-03-031 MEDS4667 License Surrendered Surrender license while under audit for CME; unable

to comply w/ CME reqrmts for lic renwl


10/23/2003 Moceri, Johnathan David MD 2800-03-041 MEDS4160 License Surrendered Surrender license while under audit for CME; unable



10/23/2003 Glasgow, Mark Lawrence MD 2800-03-051 MEDS3821 License Surrendered Surrendered license while under investigation; lic

surrendered in KY for substance abuse


10/23/2003 Ackley, Dean Ralph MD 2800-03-045 MEDS2321 Memorandum of Agreement including

Reprimand; Civil Fine of $3,500

w/$2,000 suspend; CME reqrmts

including mandatory audit for 2

licensing periods

Failure to meet CME requirements of law; failed to

disclose on renewal form

None

10/23/2003 Aaron, Deborah L. MD 2800-02-037 MEDS4339 Release from MOA Released from requirments of 09/27/02 MOA Cannot practice in Alaska

10/23/2003 Pellicciaro, Marc David MD 2850-02-002 MEDS4850 Released from MOA Released from requirements of 07/01/02 MOA; met

requirements of WA & HI stipulations.

None

10/17/2003 Dinon, Matthew Alfred DO 2802-00-006 MEDO2662 Adopted hearing officers decision to

take no action against license

Board adopted hearing officers decision to take no

action against license

None

Page 33 of 45






DATE OF


8/7/2003 Gano, Roger G. MD 2800-03-023;

2800-01-066

MEDS4138 License Suspension Board suspended license for violation of MOA;

license suspended for 1 yr; must continue to copmly

w/ MOA requirements

Cannot practice for 1 yr

8/7/2003 Boesch, Daniel E. MD 2800-03-018 MEDS3592 Memorandum of Agreement w/

Reprimand & civil fine of $1,000


by law

None

8/7/2003 McKinley, Gena K. MD 2800-02-045 MEDS4660 Released from MOA Released from terms of 10/24/02 MOA None

8/7/2003 Palmer, Martin MD 2800-03-005 MEDS756 Memorandum of Agreement w/

Reprimand, Civil Fine of $10,000 w/

$5,000 suspended, probation for 2 yrs

Violated permanent prohibition from writing scripts for

Schedule II controlled medications that resulted from

1978 felony conviction

Probation monitoring for 2 yrs

8/7/2003 Willis, Donald C. MD 2800-03-037 MEDS4825 License Surrender Surrendered while under investigation for failure to

disclose past employment history in application


8/1/2003 Jones, Miles James MD 2800-02-18 MEDS4586 Amended Accusation Filed Licenses revoked or suspended in other states; (WI,

ND, VA, MO, NY, AL, KS); failure to disclose

investigations/actions in renewal;

6/19/2003 Byford,Kyndra Dee MICP 2808-03-001 MEDM375 Nondisciplinary Memorandum of

Agrmt

Extension of time to obtain required CME for license

renewal

None

5/20/2003 Fox, Robert S. MD 2800-03-012;

2800-03-32

MEDS3462 License Suspended Voluntary suspension of license while under active

investig re: allegations of inapprop prescrib controlled

subst and drug diversion; violation of patient-

physician relationship; concerns of impairment


4/29/2003 Smith, Mark Bernard MD 2850-03-003 medl2605 Memorandum of Agreement w/

Reprimand & civil fine of $1,000

MOA w/ fine and reprimand for failure to provide

required information on a new license application

4/18/2003 Bullock, Clarence PA-C 2806-02-08 PADA375 License Surrendered Voluntary surrender of license due to allegations of

sexual misconduct while providing medical care to

female pts in custody of Dept of Corrections; Case #

3AN-S02-7264CR


4/3/2003 Ling, Louis A. MD 2800-02-061 MEDS2732 Memorandum of Agreement w/


Failure to report malpractice settlement in

accordance w/ state law

None

4/3/2003 May, April A. PA-C 2856-02-002 PADA597 Memorandum of Agreement w/

Probation, Reprimand, Civil Fine of

$1,000

Failure to provide truthful information in applications

to board

Probation for 5 years; license to be issued upon successful execution

of MOA

4/3/2003 Jones, Miles J. MD 2800-02-18 MEDS4586 Order for Suspension of License Board suspended license based on license

suspension in VA and revocation in ND


1/31/2003 Biehl, Roger Cory MD 2800-01-078 MEDS4711 Termination of Memorandum of

Agreement w/ license probation

Satisfied boards previous probation; released from all

terms and provisions of 10/26/01 MOA

None

1/30/2003 Bundtzen, Joan LaValle MD 2800-02-059 MEDS2072 Nondisciplinary Memorandum of

Agreement

Extension of time to obtain required CME for license

renewal

1/30/2003 Schurig, Samuel Herman DO See file for

compl list of

invest case

numbers

MEDO1967 Memorandum of Agreement w/ Civil

fine of $40,000 w/ $10,000

suspended; lic susp 24 mos; perm

surrender of DEA for Sched. II & III

Failure to provide approp med care to pt; obj to

boards order for psychological testing; did not admit

sexual misconduct w/ pt

see file for complete terms of agreement; cannot practice in Alaska

Page 34 of 45






DATE OF


12/20/2002 Killebrew, David S. MD 2800-99-007 MEDS2656 Adopted hearing officers decision incl.

license suspension for 180 days, civil

fine of $6,000, 8 yrs probation, perm

total abstinence from alcohol & drugs,

monitoring & treatment

Violation of previous MOA by continuing to consume

alcohol while under probation, consumed alcohol then

provided medical services to pts, unprofessional

conduct, obtained AK license thru intentional

misrepresentation

License to be suspended within 60 days of board action unless

reconsideration granted or action appealed to Superior Ct. Other

sanctions to be imposed following resolution of possible request for

reconsideration or appeal to Superior Ct.

12/20/2002 Bautista, Marciano D. DO 2802-02-31 MEDO4535 Memorandum of Agreement with civil

fine of $5,000 w/ $3,000 suspended,

reprimand

Failure to maintain DEA registration; continued to

prescribe controlled meds w/ expired DEA

None

12/12/2002 Davidhizar, Lavern R. DO 2802-00-002;

2802-99-001

MEDO1454 Termination of 2-Yr Probation Satisfied terms of probation imposed 10/27/00 None

12/6/2002 Stewart, George L. MD 2800-00-31;

2800-02-34

MEDS926 Memorandum of Agreement; Civil

Fine of $10,000 w/ $7,000 susp;

Reprimand

Sexual misconduct and unprofessional conduct None

12/5/2002 Kaniadakis, Steven J. DPM 2804-99-005 MEDP2981 Amended Accusation Accusation amended to include counts of engaging in

deceit, fraud, or intentional misrepresentation while

providing prof services; convictions for health care &

mail fraud are unprofessional conduct

11/22/2002 Schurig, Samuel H. DO 2802-00-08;

2802-02-17;

2802-02-21

MEDO1967 Amended accusation Additional counts alleging professional incompetence,

gross negligence, repeated negligent conduct; failure

to maintain approp records; failur to comply w/ board

order; intentionally or negligently permitting pt care by

persons under supv that does not conform to

minimun prof standards; prescr drugs in violation of

law; alleged sexual contact or impropriety w/ pt; prof

incompetence likely to endanger pts.

11/19/2002 Jones, Miles James MD 2800-02-18 MEDS4586 Accusation License in North Dakota revoked; license in VA

suspended

11/12/2002 Van Houten, Jay D. DO See file for

compl list of

invest case

numbers

MEDO2780 Summary Suspension Upheld

following Hearing

Board adopted Hearing Officer decision that license

should be suspended pending disposition of a

disciplinary proceeding by accusation (accusation

filed 08/28/02)


11/7/2002 Schurig, Samuel H. DO 2802-00-08;

2802-02-17;

2802-02-21

MEDO1967 Accusation Alleged professional incompetence, gross

negligence, repeated negligent conduct; failure to

maintain approp records; failur to comply w/ board

order; intentionally or negligently permitting pt care by

persons under supv that does not conform to

minimun prof standards; prescr drugs in violation of

law; alleged sexual contact or impropriety w/ pt; prof

incompetence likely to endanger pts.

10/25/2002 Makim, Jayesh Dhiraslal MD 2850-01-008 MEDS3215 Revision to Memorandum of

Agreement

Modified requirements re treating physician reports to

bd & medication testing levels

Conditions still apply

Page 35 of 45






DATE OF


10/25/2002 Morikawa, Patricia Gera MD 2850-02-005 none License Application Denied Board member reviewed the app & reqstd addl info

from residency program and full board interview;

applicant did not comply and bd interpreted

comments in her letter that she would not comply;

denied license for failur to comply w/ bds requests

Not licensed in AK

10/24/2002 Azure, Lynette M. PA-C 2856-02-001 PADA336 Memorandum of Agreement;

Reprimand and civil fine of $1,000 w/

$500 suspended

Failure to disclose investigation in another state in her

application for AK license

None

10/24/2002 McKinley, Gena K. MD 2800-02-045 MEDS4660 Memorandum of Agreement;

Probation for 5 years, Reprimand,

civil fine of $10,000 with $5,000

suspended

Electronically forged controlled substance prescr to

spuse using names of other phys w/o their

knowledge, pupose of obtaining drugs for personal

use; issued controlled subst scripts to an employee

who provided them to phys for personal use

Probation to include psychiatric care w/ monitoring of meds used;

ongoing counseling/therapy; quarterly reports to board; random testing

10/24/2002 Yarusso, James Nicholas MD no case opened none License Application Denied Bd requested eval; Applicant declined to comply;

license application denied for failure to comply w/ bds

request

Not licensed in AK

10/24/2002 Schurig, Samuel H. DO 2802-00-08 MEDO1967 Summary Suspension Failure to submit to examinations order by board Aug

2002; review of file documents by experts indicates

likely mental health problems; suspected problems

may pose a risk to pts



compl list of

invest case

numbers

MED2780 Summary Suspension Lic suspended based on expert reports/opinions that

demonstrate clear patterns of substandard practice;

failure to sufficiently evaluat pts for prescribing

controlled meds; failed to re-eval pts to assess

success of tx; failed to alter prescrb practices for

overuse/abuse of meds prescrib; allegation that

substandard care was major factor in death of one pt

& open prescrib pract contributed significantly to

addiction & subseq death from overdose of another

pt



compl list of

invest case

numbers

MEDO2780 Accusation Filed Fifteen counts of substandard care detailed; one

count related to federal indictment that includes 83

counts of health care fraud, one count of conspiracy

to commit health care fraud

8/28/2002 Beal, David D. MD 2800-99-098 MEDS798 Memorandum of Agreement;

Reprimand and civil fine of $1,000

Failure to report a malpractice settlement to the

board within 30 days after resolution of the claim as

required by law

None

Page 36 of 45






DATE OF


9/27/2002 Aaron, Deborah L. MD 2800-02-037 MEDS4339 Memorandum of Agreement;

Reprimand, Civil fine of $5,000 w/

$4,500 suspended; probation 5 yrs

Wrote controlled substance scripts for person with

whom she was involved in personal relationship &

residing; no physician-patient relationship

Five-year probation

8/1/2002 Stanford, Thad C. MD 2801-00-2 MEDS3865 Memorandum of Agreement; Civil fine


Practiced medicine with a lapsed license from Jan 1,

1999 thru April 1, 2000

None

8/1/2002 Dente, Joseph B., Jr. MD 2850-02-001 MEDS4938 Memorandum of Agreement, personal

health matters

Applicant disclosed personal health matters in

application for license that required consideration by

the full board.

License approved pending successful execution of MOA with practice

restrictions, treatment requirements, and monitoring.

8/6/2002 Schurig, Samuel H. DO 2802-00-8 MEDO1967 Board Order Issued Order to submit to psychiatric/psychological, and

medical evaluations including biological testing to

determine safety to practice; must be completed

within 60 days of order.

None


2800-02-34

MEDS926 Board Order Issued Order to submit to psychiatric/psychological, and

medical evaluations including biological testing to

determine safety to practice

None

8/1/2002 Winczura, John A. J. PA-C 2806-00-1 PADA441 Denial of Petition to Restore License Petition to restore license denied by board based on

chemical dependency issues

Cannot practice in AK; board specified longer period of recovery before

license may be restored

7/31/2002 Kaniadakis, Steven J. DPM 2804-99-005 MEDP2981 Accusation Filed Convictions of healthcare & mail fraud; DOL is

seeking revocation, suspension, or other sanctions

from board

7/9/2002 Grube, Lorraine G. PA-C 2806-02-7 PADA546 Memorandum of Agreement;

requiring complete physical,

neurological and psychiatric evals

Allegations of chemical impairment while practicing in

Galena

Cease practicing as a PA, undergo exams, agree to monitoring &

probation if approp; consume no controlled drugs, submit to random

tests

7/1/2002 Pellicciaro, Marc D. MD 2850-02-002 MEDS4850 Memorandum of Agreement Substance abuse history; being monitored by WA &

HI boards

Five-yr probation with monitoring, reports to board


2800-02-34

MEDS926 Accusation Filed Allegations of violations of unprofessional conduct

and ethics laws

4/26/2002 Nathanson, Steven Eric MD See file for

compl list of

invest case

numbers

MEDS1429 License Surrendered Surrendered license while in administrative hearing Cannot practice in Alaska

4/4/2002 Hagglund, Howard Edward MD 2800-01-040 MEDS2891 License Surrender Failed to comply with CME laws, surrendered license

in lieu of discipline


4/4/2002 Boettcher, William G. MD 2800-01-056 MEDS1054 Memorandum of Agreement w/ civil

fine of 2,000, reprimand


disclose on renewal form; failed to report malpr

settlements

None

2/28/2002 Winczura, John A. J. PA-C 2806-00-01 PADA441 Accusation Filed Allegations of practicing medicine while under the

influence of alcohol; inappropriate care

1/18/2002 Bedder, Helen F. MD 2850-01-011 MEDT2042 Memorandum of Agreement, personal

health matters

Applicant disclosed personal health matters in

application for license that required consideration by

the full board.

License approved pending successful execution of MOA with practice

restrictions, treatment requirements, and monitoring.

1/17/2002 Winczura, John A. J. PA-C 2806-00-1 PADA441 Denial of Petition to Restore License Petition to restore license denied by board based on

chemical dependency issues

Cannot practice in AK; board specified longer period of recovery before

license may be restored

1/17/2002 Barton, Theodore Douglas MD 2800-01-017 MEDS1793 Memorandum of Agreement w/ civil


Failure to report malpractice claim settlement None

Page 37 of 45






DATE OF


1/17/2002 Morresey, Leo K. MD 2800-01-084 MEDS1407 Memorandum of Agreement w/ civil


reprimand

Practicing medicine without a valid license, license

expired 12/31/00, failed to renew and continued to

practice

None

1/17/2002 Makim, Jayesh MD 2850-01-008 MEDS3215 Modification to 05/25/01

Memorandum of Agreement

Removed requirement for hospital privileges from

Memorandum of Agreement, all other requirements

remain

Conditions apply, see agreement

12/3/2001 Nathanson, Steven Eric MD See file for

compl list of

invest case

numbers

MEDS1429 Summary Suspension Continued practice poses clear and immediate

danger to public

Cannot practice in AK; if attempts to reinstate lic, must prove safe to

prac

11/15/2001 Nelson, Jennifer L. MICP 2808-98-2 MEDM145 License Surrender License surrendered while under active investig. for

personal health concerns re allegations concerning

fitness to practice

10/26/2001 Lewis, Jim E. DO 2802-98-02;

2802-98-07

MEDO1903 Summary Suspension Sexual misconduct; lic surrender in other state Requirement for medical, psychiatric, and psychological evaluations

before petitioning for restoration of license

10/26/2001 St. John, Philip C. MD License application denied Failure to disclose past investigatory & discipl hx in

other state; revocation stayed in CA and placed under

5 yr probation in 2000


10/26/2001 Valdez, Guillermo Bernardo (aka

Bernardo Guillermo Valdez)

MD 2850-01-10 none License application denied Failure to disclose past incarcerations including

federal prison, alleged misconduct w/ controlled

substances, charges for prac med w/out lic in GA,

arrest record for violating prescribing laws, DEA

charges, more…


10/26/2001 Biehl, Roger C. MD 2800-01-78 MEDS4711 Nondisciplinary Memorandum of

Agreement - health reasons

Disclosed personal health considerations in

application

10/26/2001 Heller, Margaret B. PA-C 2806-01-008 PADA504 Memorandum of Agreement;

Reprimand and Civil fine of $1,000 w/

$500 susp;

Practiced medicine without valid collab plan No restrictions or conditions

10/25/2001 Congdon, Jeffrey C. MD 2850-01-20 License application denied Failure to disclose past substance abuse hx and

residency training hx in application


9/24/2001 Beal, David Dixon MD 2800-99-098 MEDS798 Accusation Filed Failure to report malprac settlement within 30 days of

resolution of case

8/31/2001 Baker, Clifton Earl MD 2850-01-018 MEDS2819 MOA w/ reprimand & civil fine $3,550

w/ $2,550 susp; meet CME for past

lic periods

Failure to comply with CME laws If fails to comply w/ MOA, unsuspd portion of fine due immediately &

license suspended.

8/20/2001 Gano, Roger G. MD 2800-01-066 MEDS4138 Reinstated susp lic; Memorandum of

Agreement w/ conditions

Violated previous MOA for substance abuse; lic was

suspended 01/20/00

License restored w/ practice restrictions & conditions; 10-yr prob,

treatment requirements, prac restrict., reports to bd

8/17/2001 Vent, Sonia Mary PA-C 2806-01-003 PADA166 Memorandum of Agreement

reprimand, civil fine $2,500; extension

of orig prob by 8 mos and addition of

2 more yrs

Violated previous probation/MOA, prac w/o approval

of collab phys, practiced w/o apprvd collab plan

Probation extended

8/2/2001 Shortridge, Stephen M. PA-C 2806-01-006 PADA394 Reprimand; civil fine $1,000 Failure to disclose previous criminal charges when

initially applied for lic in 1996; discovered thru DEA

investigation

No restrictions

8/2/2001 Smith, Christopher Turner MD 2800-01-047 MEDS2271 License Surrender Failed to comply with CME laws, surrendered license

in lieu of discipline


8/2/2001 Dinneen, James Clark MD 2800-01-035 MEDS4079 Reprimand; civil fine of $3,500 w/

$1,500 suspd



No restrictions

8/2/2001 Cole, Brian MD 2850-01-009 MEDS4643 Reprimand; civil fine of $1,000 Failure to disclose past action by hosp in app No restriction; license to be issued following payment of fine

7/23/2001 Bilyeu, Stuart William DO Application Withdrawn Request for withdrawal of app granted by bd No license issued

Page 38 of 45






DATE OF


6/12/2001 Dinon, Matthew Alfred DO 2802-00-006 MEDO2662 Accusation Filed Allegation that respondent may be unsafe to practice

due to personal health concerns, hx of codependence

and medication abuse

6/7/2001 Killebrew, David S. MD 2800-99-007 MEDS2656 Amended Accusation Filed Allegations of violation of perm restrictions against

alcohol consumptn; addiction to alcohol impairs his

ability to prac safely; unprof conduct (MOA dated

12/9/01); addition of allegations intentional

misrepresentation to obtain license

5/25/2001 Makim, Jayesh D. MD 2850-01-008 MEDS3215 Memorandum of Agreement 5-yr

probation, monitoring, practice

restrictions

Surrendered license while under active invest.; for

allegations of sexual misconduct

5-yr probation w/ reqrmts for psychotherapy/counseling, medication

restr., empl & residence restrictions, chart review by reviewing

physician, employer reports, chaperone for female pts required; license

to be restored when renewal reqmts met

5/8/2001 Nelson, Jennifer L. MICP 2808-98-002 MEDM145 Memorandum of Agreement 5 yrs

prob & work restrict.

Allegations of diversion of meds; major depres.

disorder, alcohol abuse

Five-yr probation with requirements for psychotherapy/ counseling,

reports to board,

5/2/2001 Colescott, Paula Jo MD 2800-95-020 MEDS2796 End of License Probation Successful completion of 5-yr prob; lifted perm

restrictions to license

No restrictions

4/10/2001 Bucknall, Melissa D. MICP License App Denied Failure to meet threshold license reqrmts Cannot practice in Alaska

4/9/2001 Allen, Janet Kiehle MD 2850-01-006 MEDS4598 Reprimand; civil fine $2,000 Failure to disclose investigations in other state No restrictions

4/9/2001 Carter, Thomas Mark MD 2850-01-003 MEDS4623 Reprimand; civil fine $2,000 Failure to disclose disciplinary history during

residency training

No restrictions

4/9/2001 Hickman, James Murray PA-C 2807-00-001 PADA302 License Surrender License surrendered while under active invest.;

allegations of prac w/o a valid collab plan


3/8/2001 Graham, Jack L. MD 2850-98-8 MEDS4076 End of License Probation Successfully completed probation in NM, unrestricted

NM lic; AK probation connected to NM prob

Probation terminated; no restrictions on AK license

2/16/2001 Enoch, Joan Ellen MD 2800-01-012 MEDS3548 Nondisciplinary Memorandum of

Agreement

Extension of time to obtain CME for renewal No restrictions

1/24/2001 Hopson, Raymond D. MD 2850-00-017 MEDS4595 Reprimand, Civil Fine $1,000 Failure to disclose investigation in other state on

application for AK license

No restrictions

1/18/2001 Shannon, Mary Elizabeth PA-C 2806-00-005 PADA176 Reprimand; Civil fine $1,000 w/ $500

stayed of no violation of law within 6

months

Continued to practice w/out an active collab plan w/ a

doc (only prac 8 days in 2 yrs)

No violation of laws within next 6 mos.

1/18/2001 Wyatt, Sylvia A. PA-C 2806-01-1 PADA449 Reprimand Authorized use of a Schedule 2 drug w/out proper

authorization of collab doc

No restrictions

1/18/2001 Fenn, Susan K. DPM 2804-00-002 MEDP3070 Reprimand; Civil Fine of $3,000 Failed to renew DEA registration in 1990; cont to

write scripts for controlled drugs w/out a valid DEA

registration

None

1/18/2001 Leach, William Charles MD 2800-00-43 MEDS1942 License Suspended FL license suspended for allegations of sexual

misconduct; substance abuse treatment


1/18/2001 Straatsma, Glen W. MD 2800-00-070 MEDS586 Memorandum of Agreement perm

restrictions & civil fine $10,000 w/

$5,000 suspd

Restored surrendered lic w/ MOA w/ conditions

(license surrender for sexual miscond w/ pts.)

MOA w/ 5-yr probation, other perm restrictions; lic may be reinstated

after all lic renewal reqmts met; fine to be paid within 180 days of MOA

1/2/2001 McGregor, Randall Kerr MD 2800-00-085 MEDS3037 Nondisciplinary Memorandum of

Agreement

Extension of time to complete CME requirements No restrictions

1/2/2001 Voke, Edward M. MD 2800-01-001 MEDS545 Nondisciplinary Memorandum of

Agreement


12/20/2000 Akiyama, Henry Isamu MD 2800-00-079 MEDS412 Nondisciplinary Memorandum of

Agreement


Page 39 of 45






DATE OF


10/27/2000 Romeu, Hugo MD 2850-00-13 None Reprimand; Civil Fine of $2,000 Failure to disclose investigations in other state; failure

to disclose restricted lic in other state

LT permit to be issued when locum doc identified; fine has not been pd;

no lic issued

10/27/2000 Davidhizar, Lavern R. DO 2802-00-002;

2802-99-001

MEDO1454 Probation for 2 years; Civil Fine of

$5,000; Reprimand

Prescribed drugs without maintaining approp records;

leaving presigned scripts used by a PA

inappropriately

Probation requirements 2 yrs

10/27/2000 Brockman, Ronald DO 2802-00-004 MEDO1197 Reprimand; Civil Fine $5,000 Prescribed drugs w/out maintaining approp records

for a person w/ whom he acknowledge personal

relationship

None

10/27/2000 Young, Lloyd MD 2850-00-006 None License App Denied Lic app denied based on 12 AAC 40.967(18)(B) use

of illegal drugs


10/27/2000 Fisher, Arthur James DPM None License App Denied Failure to meet threshold license reqrmts Cannot practice in Alaska

8/29/2000 Hannon, Ronald Michael MD 2800-99-012 MEDS4153 License Surrendered License surrendered while under active invest. for

allegations of sexual misconduct w/ a pt and

unlicensed practice


8/29/2000 Killebrew, David Scott MD 2800-99-007 MEDS2656 Accusation Filed Allegations of violation of permanent restrict., against

alcohol consumpt; that addiction to alcohol impairs

his ability to prac safely; unprof conduct (MOA dated

12/09/91)

8/4/2000 Welker, James Glen PA-C 2807-00-002 PADA493 Reprimand, Civil Fine $2,000; license

to be issued when fine pd

Practicing medicine without a license None

8/4/2000 Rapoport, Dov MD 2800-99-054 MEDS3664 Reprimand, Civil Fine $5,000 w/

$2,000 suspended

Inappropriate prescribing to person w/ whom in

personal relationship, no pt/phy relationship; did not

prepare & maintain records

If licensee fails to comply w/ terms of MOA, suspended fine becomes

immediately payable

8/3/2000 Gano, Roger G. MD 2800-99-134 MEDS4138 Petition to Reinstate Suspended

License Denied

License suspended for violating MOA License remains suspended

8/3/2000 Shimotsu, Grace Ellen MD 2800-94-14 MEDS3227 Denied Motion for Reconsideration of

Board Decision

Board declined to reconsider its decision of 07/07/00 -

bd imposed 60-day susps, civil fine of $6,000, and

ethics course

Disciplinary sanctions remain in place; licensee appealed to Superior

Court

7/7/2000 Riehl, John Phillip MICP 2808-00-003 MEDM218 License Surrendered Surrendered license while under audit for CME;

unable or unwilling to comply w/ CME reqrmts for lic

renewal


7/7/2000 Shimotsu, Grace E. MD 2800-94-14 MEDS3227 60-Day Suspension of Lic; $6,000

fine; attend ethics course apprvd by

bd

Board adopted HOs decision following hearing; four

counts of allowing high school student to to

place/inflate Foley catheter; inject pt w/ xylocaine;

suture a wound; left ER while student performed

tasks without supervision

Must pay fine before license restored after susp; attend ethics program

w/i 12 months from date of decision

7/7/2000 Lele, Shrirang M. MD 2800-97-007 MEDS3713 License Surrendered Surrendered license while under investigation for

allegations of incompetence; Surrender signed

05/18/00; approved by board 07/07/00.


7/7/2000 Angus, George E. MICP 2808-00-002 MEDM173 License Surrendered Surrender license while under audit for CME; unable



7/7/2000 Williams, Chester L. MICP 2808-00-004 MEDM128 License Surrendered Surrender license while under audit for CME; unable



7/7/2000 Rousseau, Glenn K. MD 2850-00-009 MEDLLT-

1513

Memorandum of Agreement w/ 5-yr

probattion; alcohol dep; under 5-yr

probation in VA

MOA for 5 yrs w/ monitoring when in AK to include

report to bd, counselor/therapist repts, AA mtgs,

random tests, remote practice restrict.

Permit granted w/ restrictions in MOA for monitoring

5/11/2000 Thomasson, June M. PA-C 2807-99-5 PADA115 Reprimand; Civil Fine of $2,000 w/

$1,000 suspd

Failed to renew license & continued to practice with

an expired license

None

5/11/2000 Gottlieb, Jeffrey MD 2800-00-018 MEDS3119 Summary Suspension Indictment on 236 counts of criminal conduct

including forgery, perjury, theft, & misconduct

involving controlled substances

Cannot practice in AK; Bd will require compl med & psych eval

Page 40 of 45






DATE OF


5/4/2000 Pulliam, Andrew R. MD 2850-00-02 MEDS4516 Censure Failure to disclose investigation in other state; bd

cited extenuating circumstances

Permanent license may be issued when MOA executed

4/27/2000 Mackey, Nancy Marlene PA-C 2806-99-003 PADA211 Reprimand; Civil Fine $5,000 w/

$2,000 stayed if no similar violation

for 1 yr

Practiced w/o valid collab plan; wrote script for

Schedule II drugs

No restrictions/conditions except prov that stayed portion of fine will be

payable if further violations

4/27/2000 DaSilva, Nigel DO 2852-99-1 MEDO4468 Reprimand; Civil Fine of $2,000 Failure to disclose investigation in other state; failure

to disclose malprac info on application

None

4/27/2000 Davoli, Michael James, II MD 2850-00-002 None Reprimand; Civil Fine Failure to disclose investigation in other state on

license application

Board approved LT permit contingent on MOA w/ sanctions (Davoli

declined to agree to MOA w/sanctions; requested a hearing; later

withdrew request for hearing; never issued a permit in Alaska.)

2/29/2000 Nathanson, Steven Eric MD 2800-97-5,48;

2800-99-14, 23,

24, 35, 36, 37,

53, 65, 77

MEDS1429 Amended Accusation Filed Allegations of prof incompetence; allegations of

repeated negligent conduct; allegations of violation of

malprac reporting laws

1/21/2000 Jagh, Claude Dalton MD None None License App Denied App denied for failure to pass approp exams required

for licensure


1/21/2000 Minkoff, Irene Monida MD None None License App Denied App denied for failure to pass approp exams required

for licensure


1/21/2000 Mujica, Patricio Hernan MD None None License App Denied App denied for failure to pass approp exams required

for licensure


1/20/2000 Bleicher, Michael A. MD 2800-97-055 MEDS2039 Reprimand; Civil Fine of $1,000 Board adopted Hearing Officers decision for failure to

meet CME reqrmts for lic renewal; failure to comply

w/ Chapter 64

No restrictions or conditions

1/20/2000 Gano, Roger G. MD 2800-99-134 MEDS4138 License Suspended License suspended indef for violating MOA Cannot practice in AK; if attempts to reinstate lic, must prove safe to

prac

1/20/2000 Craddick, Steven L. PA-C 2806-99-006 PADA250 Reprimand; Civil fine of $5,000 w/

$3,000 suspended

Removed controlled substance meds from place of

employment w/o collab docs knowled. &

administering to dying sister

No restrictions or conditions

1/20/2000 McRae, Donald R. MD 2800-94-7 MEDS2811 License Suspended License voluntarily suspended while under active

investigation; under agrmt w/ GA bd


prac

1/20/2000 Bentley, Steven E. MD 2800-99-129 MEDS2470 License Surrendered License surrendered while under active investigation;

allegation of substance abuse; entered agrmt w/ NC

bd; surrender signed 01/13/00, adopted by bd

01/20/00


prac

1/20/2000 Kendall, Kevin M. MD 2800-97-029;

2800-99-130

MEDS3214 License Surrendered License surrendered under active investigation,

allegations of subst abuse; entered agrmt w/ ME bd;

surrender signed 01/21/00, adopted by bd 01/20/00


prac

1/20/2000 Cannon, Scott L. MD 2800-00-013 MEDS3351 Nondisciplinary agreement for

extension of time to obtain CME

Disclosed failure to obtain necessary CME on

renewal form

No restrictions

1/20/2000 Jarrell, John Percha MD 2850-99-4 MEDS4273 Board denied petition to reinstate

suspended license

Violated terms of MOA dated 06/16/99; Bd reqs 2-3

yrs of sobriety


12/13/1999 Heder, Lane O. PA-C 2807-99-006 PADA403 License Surrender License surrender while under active investiga. for

allegations of prac w/o valid license; surrender signed

11/05/99; board approved 12/13/1999

No longer licensed in AK

12/13/1999 Jarrell, John P. MD 2850-99-004 MEDS4273 License Suspended License suspended indef for violating MOA Cannot practice in AK; if attempts to reinstate lic, must prove safe to

prac

Page 41 of 45






DATE OF


10/21/1999 Teissler, Hana MD 2800-99-043 MEDS2966 License Surrender Failed to meet requirements of CME laws; failed to

disclose on renewal; lic surrendered 08/23/99, bd

apprvd and issued order 10/21/99


10/21/1999 Gabler, Ann MICP 2808-99-001 MEDM27 License Surrender Failed to meet requirements of CME laws; failed to

meet requirements of 1/22/99 MOA


10/21/1999 Klepp, A. Leonard MD 2800-99-052 MEDS3175 License Surrender License under investigation for questions re:

investigation in CA; surrender signed 10/16/99, bd

apprvd and issued order 10/21/99


10/21/1999 Stowens, Daniel W. MD None License App Denied Application for license denied due to unresolved

action in another state

8/19/1999 Nathanson, Steven E. MD 2800-97-05;

2800-97-48;

2800-99-14;

2800-99-35;

2800-99-36

MEDS1429 Accusation Filed Allegations of prof incompetence; allegations of

repeated negligent conduct; allegations of violations

of malprac reporting laws

8/5/1999 Campbell, Barry Lee PA-C 2807-99-3 PADA88 Reprimand; Civil Fine of $2,000 w/

$1,000 suspended

Failure to renew license; practiced med w/o active

license

8/5/1999 Michaud, Robert Merrill DO 2802-98-1; 2802-

98-3; 2802-98-4;

2802-99-3; 2802-

99-4

MEDO3638 Denied Petition for Reinstatement of

surrendered license

Requested reinstatement of surrended lic; lic was

surrendered while under investigation; actions by UT

and AZ boards

License remains surrendered

8/5/1999 Maddox, Lisa Marie MD 2850-98-06 MEDS4178 Released from terms of prev MOA Petitioned for release from terms of MOA that

required practice monitoring

License released from terms of MOA; unrestricted

7/20/1999 Thornquist, Robert K. MD 2800-94-006 MEDS2198 Probation Completed MOA adoped by board 7/20/94 completed No on-going restrictions/conditions

6/16/1999 Jarrell, John P. MD 2850-99-4 MEDS4273 5-Year Probation; Chem Dep Disclosed Consent Order w/ MS; treatment for chem

dep; lic approved by bd w/ psych eval and 5-yr

probation

License granted with conditions

6/16/1999 Grandstaff, Stephen W. MD 2800-98-3; 2800-

99-25

MEDS2869 License Surrender Surrendered while under investigation for allegations

of sexual misconduct & other misconduct; surrender

signed 06/10/99, approved by bd and order issued

6/16/99


6/16/1999 Marascalco, John Andrew MD 2800-98-36 MEDS2818 Reprimand; Civil Fine of $5,000 Alleged noncompliance w/ CME; alleged false

statement on renewal; decision following admin

hearing

CME conditions apply

6/16/1999 Michaud, Robert M. DO 2802-98-1 MEDO3638 License Surrender License under investigation re: validity of answers in

initial app; also under investigation/allegations re pt

treatment issues


6/16/1999 Ballard, John M. MD 2800-99-31 MEDS3684 Reprimand; Civil Fine of $3,000,

$2,000 suspend; CME reqrmts



6/16/1999 Fox, Robert S. MD 2800-99-30 MEDS3462 Reprimand; Civil Fine of $3,500; CME

requirements



4/16/1999 Lucero, Joseph W. MD 2850-98-12 None Reprimand, Civil Fine of $3,000;

license to be issued when fine pd

Failure to disclose disciplinary sanction during

residency in app; decision following admin hrg

License not issued; Reprimand issued; Fine not paid

4/16/1999 Sorgen, Richard A. MD 2850-98-10 MEDS4214 License Surrender Stated inability to comply w/ terms of MOA; surrender

signed 04/12/99, bd apprvd 4/16/99


4/16/1999 Straatsma, Glen W. MD 2800-98-21 MEDS0586 Denied Petition to Reinstate License License surrendered following conviction of 2nd

degree sexual assault; petition to restore lic denied by

bd


2/24/1999 Oxford, Jennifer Jan PA-C 2807-99-1 PADA448 Reprimand; Civil Fine of $2,000 Failed to notify bd of chg in collab plan; pracd without

primary collab phys

No restrictions

Page 42 of 45






DATE OF


2/24/1999 Kyzer, David D. MD 2800-99-08 MEDS1763 License Surrender Surrendered license due to personal health problem No longer licensed in AK

2/24/1999 Baker, Gary J. PA-C 2806-97-01 PADA180 License Surrender Lic previously summary suspended w/ reqrmt for

psych & med exams; surrendered after convictions

for misdemeanor sexual assault of female patients


2/24/1999 Sorgen, Richard A. MD 2850-98-10 MEDS4214 Probation Monitoring Disclosed personal health issues in lic appl;

Memorandum of Agreement for monitoring

License granted with conditions including eval, monitoring and

employer reports

2/24/1999 Leach, William Charles MD 2800-99-06 MEDS1942 Nondisciplinary agreement for


Disclosed failure to obtain CME on renewal

application

No restrictions

1/22/1999 Cormack, Alvin P. MD 2800-98-43 MEDS998 License Suspended Suspended in other states; suspd in AK while under

investigation; alleged sexual exploitation of patient

Suspended until actions in other states resolved; must prove safe to

practice in AK before license may be restored; no longer licensed in AK

1/22/1999 Gabler, Ann M. MICP 2808-99-01 MEDMM 27 Nondisciplinary agreement for


Disclosed failure to obtain CME on renewal

application; license renewed under conditions of

extension agreement

No restrictions

1/21/1999 Straatsma, Glen W. MD 2800-98-21 MEDS0586 License Surrender License surrendered 12/23/98; bd apprvd and order

issued 01/21/99; allegations of sexual misconduct w/

patient


1/21/1999 Rogers, Donald Robert MD MEDS708 Nondisciplinary agreement for


Disclosed failure to meet CME reqmts on renewal

application; reqstd extension of time to comply

No restrictions

1/21/1999 Lindig, Jr., Edwin MD MEDS0543 Reprimand, Civil Fine of $1,000, CME

requirements

Failure to meet CME requirements, failed to disclose

on renewal application

CME requirements in MOA

1/21/1999 Watson, James Brentz MD MEDS1298 Nondisciplinary agreement for


Disclosed failure to meet CME reqmts on renewal

application; reqstd extension of time to comply

No restrictions

1/21/1999 Maddox, Lisa Maria MD 2850-98-06 MEDS4178 3-Year Probation w/ practice

monitoring and reports to board

Disclosed problems in residency training on license

application

3-Year Probation; Conditions Apply

12/28/1998 Lucero, Joseph W. MD 2850-98-12 None Hearing Requested License not issued; applicant refused conditions of

licensure (civil fine); reqsted admin hearing

12/7/1998 Marascalso, John Andrew MD MEDS2818 Accusation Filed Alleged noncompliance w/ CME laws; alleged false

statement on renewal form

12/7/1998 Bleicher, Michael Alan MD MEDS2039 Accusation Filed Alleged noncompliance w/ CME laws; alleged false

statement on renewal form

11/20/1998 Lucero, Joseph W. MD 2850-98-12 MEDL617 Civil Fine of $1,000 Failure to disclose disciplinary in residency program


License to be issued w/ discipline; license not issued - applicant did not

agree; admin hearing held

11/19/1998 Benjamin, Zan MD 2800-97-046 MEDS3747 Memorandum of Agreement to

reinstate lic w/reprimand, civil fine of

$1,000, 5-yr probation

Licensee under investigation for alleged drug

diversion; false answer on initial app; surrendered lic

12/4/97

License granted with discipline and 5-year probation

11/19/1998 Whelan, Francis J. MD 2800-98-035 MEDS0906 Reprimand, Civil Fine of $3,500 and

CME requirements


on renewal appl


10/21/1998 Gano, Roger Glenn MD MEDS4138 Memorandum of Agreement w/ 5-

Year Probation for chemical

dependency

Disclosed in application chemical dependency and

agreed to probation

License granted with 5-year probation

10/2/1998 Ruben, Samuel Mark MD 2850-96-017 MEDS4216 Reprimand; Civil Fine $1,000 Failed to disclose investigation in other state in

application; initially denied; negotiated settlement to

include disciplinary sanctions

License granted with discipline

8/28/1998 Foster, Kenneth W. MD None License Application Denied Licensed revoked in CA & LA Not licensed in AK

Page 43 of 45






DATE OF


8/27/1998 Steinhilber, Ernest John MD 2850-98-019 MEDS4134 Reprimand; Civil Fine $1,500 Board Adopted Hearing Officers Decision for failure

to disclose investigation in other state on license

application


8/27/1998 Baker, Clifton Earl MD 2850-01-018 MEDS2819 Reprimand; Civil Fine $3,500; Applied for reinstatement of expired lic; failed to

obtain CME; failed to disclose on renewal form

License to be reinstated w/ discipline; licensee has not complied -

license has not been issued, remains lapsed

8/26/1998 Denney, Teresa Ann DO 2850-97-003 MEDO4136 Decision and order following hearing;

Reprimand and Civil Fine of $500

Failure to disclose investigation in other state on

license application; went to admin hearing


8/26/1998 Cole, Elisabeth-Anne D. MD MEDS4133 Reprimand; Civil Fine $1,000 Failure to disclose investigation in other state on

license application


8/26/1998 Vent, Sonia Mary PA-C 2806-98-004 PADA166 Reprimand; Civil Fine of $500; 3-yr

probation

Fraudulent use of physician name; drug diversion

(non-controlled meds)

3-Year Probation; Conditions Apply

8/3/1998 Behymer, Kenneth MD 2800-98-31 MEDS838 License Surrender Surrender due to personal illness signed 07/30/98;

apprvd by board and order issued 08/03/1998


7/20/1998 Croy, Daniel Jack MD 2850-97-11 MEDS4090 Reprimand; Civil Fine $1,000 Failure to disclose prior investigation in other state;

initially denied licensure but later agreed to discipline


6/30/1998 Graham, Jack L. MD 2850-97-004 MEDS4076 Reprimand, Civil Fine $1,000, MOA

for chm dependency

Violated conditions of MOA dated 07/01/98 Probation conditions apply

6/5/1998 Shimotsu, Grace Ellen MD 2800-94-14 MEDS3227 Accusation Filed Allegations of conduct not conform to min prof

standards, alleged fraud

5/28/1998 Straastma, Glen W. MD 2800-98-21 MEDS0586 License Suspended; conditions for

reinstat or restoration

Alleged sexual misconduct w/ patient No longer licensed in AK

05/28/1998 Gray, Scharazard Lee MD 2800-95-015 MEDS2940 Denied Petition to Reinstate License Petitioned for reinstatement of lic surrendered

07/10/95; admin hearing held; petition denied (crack

cocain addiction)


5/28/1998 Gould, Ronauld J. MD 2800-98-001 MEDS1331 License Suspended; Reprimand; Civil

Fine of $3,500; CME requirement

Failure to meet CME requirements; failure to disclose

on renewal

License suspended

5/28/1998 Hunter, John D. MD 2800-97-056 MEDS2921 Reprimand; Civil Fine of $2,700 w/

$2,000 suspended; CME reqmts


on renewal


5/28/1998 Kelly, Richard J. MD 2800-98-002 MEDS3123 Reprimand; Civil Fine of $2,900 w/

$2,000 suspended; CME reqmts


on renewal


4/24/1998 Makim, Jayesh D. MD 2800-98-18 MEDS3215 License Surrender License surrendered while under investigation;

alleged unfit to practice due to emotional/mental

instability


4/23/1998 Ryan, Michael E. MD 2850-98-04 MEDL571 Reprimand; Civil Fine $1,000 Failed to disclose investigation in other state on

license application

Permit granted with discipline

4/23/1998 Savikko, Douglas M. DO MEDO1667 Probation Ended Satisfied terms of 5-yr probation Permanent restriction against alcohol/drug consumption

4/14/1998 Gregory, Richard J. MD 2800-95-031 MEDS2275 License Surrender License surrendered 03/26/98; apprvd by board and

order issued 04/14/98

Not licensed in AK

4/14/1998 Davenport, Wayne A. MD 2800-95-21 MEDS1178 License Surrender License surrendered 03/31/98; under invest.; apprvd

by board and order issued 04/14/98 to be effective

06/01/98


3/16/1998 Threet, Richard W. MD 2850-95-03 MEDS3590 License Surrender License surrendered 02/11/98; apprvd by board and

order issued 03/16/98

Not licensed in AK

2/6/1998 Berg, Susan MD 2850-97-015 None License Application Denied Unfit to practice due to mental or physical disability;

action in other state against license

Not licensed in AK

2/6/1998 Barran, Peter D. MD 2850-97-008 None License Application Denied License action in another state; prof unfit; felony

conviction; license suspended in other state

Not licensed in AK

Page 44 of 45






DATE OF


2/6/1998 Cole, Elisabeth-Anne D. MD None License Application Denied Failed to disclose investigation in other state on

license application

Not licensed in AK

2/6/1998 Shah, Varsha N. MD None License Application Denied Failed exam requirement; professional

incompetende; professional unfit

Not licensed in AK

2/6/1998 Fisch, Ardis B. MD 2850-97-016 MEDS3976 Reprimand; Civil Fine $1,000 Failed to disclose academic probation in med school


No restrictions

2/6/1998 Veraas, Per Olav DPM License Application Denied Did not meet threshold reqrmts for licensure Not licensed in AK

2/3/1998 Beirne, Mark Joseph MD MEDS2477 Cease & Desist Order Practiced med w/out a license; license surrendered

03/07/95


12/4/1997 Engel, Eileen G. MD 2850-96-011 MEDS3974 Decision and order following hearing Reprimand for failure to disclose investigation in other

state on license application

Granted license w/ reprimand; unrestricted

12/4/1997 Benjamin, Zan MD 2800-97-046 MEDS3747 License Surrender License surrendered 10/20/97; approved by board

and order issued 12/04/97


9/26/1997 Croy, Daniel J. MD 2850-97-011 None License Application Denied Failed to disclose investigation in other state on

license application

Not licensed in AK

9/26/1997 Steinhilber, Ernest John MD 2850-97-019 None License Application Denied Failed to disclose investigation in other state on

license application

Not licensed in AK

9/26/1997 Swircenski, Mark PA-C 2806-97-05 PADAPA235 Memorandum of Agreement w/

reprimand

Practiced med w/out valid plan of collaboration None

7/11/1997 Chaplin, David M. MD 2850-97-006 None License application denied Basic qualification Not licensed in Alaska

7/11/1997 Cormin, Frank E. Jr. MD 2850-96-010 None License application denied Suspension of license in Texas Not licensed in Alaska

7/11/1997 Denney, Teresa Ann MD 2850-97-003 None License application denied False application response. Not licensed in Alaska

7/10/1997 Pulley, Lee G. MD 2850-97-002 None License application denied Provided false information on application Not licensed in Alaska

7/1/1997 Graham, Jack L. MD 2850-97-004 MEDL279 Memorandum of Agreement History of substance abuse Duration of practice to be July 1 - July 20, 1997. Enter into ASMA PAC.

Consume no controlled drug, alcohol, or legend drug undless

prescribed by his doctor or dentist. Health Care Provider Support

Group via ASMA. UA/Blood/Hair tests. Work location restriction.

Employer reports. Notify Hospitals of MOA. Comply with all laws.

4/4/1997 Benson, Robert MD 2850-96-015 None License application denied Provided false information on application Not licensed in Alaska

4/4/1997 Roundtree, Silvernne P. MD 2850-96-010 None License application denied Provided false information on application Not licensed in Alaska

4/4/1997 Tulliue, Daniel L. MD 2850-97-009 None License application denied License suspended in Colorado at time of application

for Alaska license

Not licensed in Alaska

2/19/1997 Baker, Gary J. PA-C 2806-97-001 PADA180 Summary Suspension Sexual misconduct involving female patients Cannot practice in AK; req medical and psychiatric examinations

Page 45 of 45

Documents

ALASKA STATE MEDICAL BOARD SUMMARY OF BOARD