GEORGIA COMPOSITE MEDICAL BOARD MINUTES JULY 10, …GEORGIA COMPOSITE MEDICAL BOARD MINUTES JULY 10, 2014 1 The Georgia Composite Medical Board (GCMB) held its regular meeting on July

GEORGIA COMPOSITE MEDICAL BOARD

MINUTES

JULY 10, 2014

1

The Georgia Composite Medical Board (GCMB) held its regular meeting on July 10, 2014 at 2

Peachtree St., NW 36th

Floor, Atlanta, GA 30303 to consider Medical Board matters.

Board members in attendance on Thursday, July 10, 2014 were:

David Retterbush, MD, Chairperson

Alice A. House, MD, Vice Chairperson

John S. Antalis, MD

William Butler, MD

E. Daniel Deloach, MD

Charmaine Faucher, PA-C, Ex-Officio Board Member

Alexander S. Gross, MD

Jeffery Grossman, M.D.

Jane “Cami” McGarity, Consumer Member

B. K. Mohan, MD

Trey Powell, M.D.

Ronnie Wallace, Consumer Member

Richard Weil, MD

Charles White, DO

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

William S. Sightler, DO

Representatives from the Attorney General’s Office:

Amelia Baker, Senior Assistant Attorney General

Wylencia H. Monroe, Senior Assistant Attorney General

D. Williams-McNeely, Assistant Attorney General

David Stubins, Assistant Attorney General

CALL TO ORDER

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

AGENDA

Dr. Butler submitted a motion, seconded by Dr. Deloach, to approve the agenda of the July 10, 2014

meeting. The motion carried unanimously.

MINUTES

Dr. Deloach submitted a motion, seconded by Dr. Gross, to approve the minutes of the June 5-6,

2014 meeting with amendments. The motion carried unanimously.

Dr. Weil submitted a motion, seconded by Dr. Butler, to approve the minutes of the June 17, 2014

teleconference meeting.


MINUTES

JULY 10, 2014

2

Dr. Retterbush and Ms Hughes recognized Phyllis White for her sixteen years of service with the

State.

Ms. Hughes introduced Jeffery Grossman, M.D., new Board Member, to the Board.

EXECUTIVE DIRECTOR’S REPORT

LaSharn Hughes, Executive Director, presented the following information for the Board’s review.

Dr. Deloach submitted a motion, seconded by Dr. Mohan, to accept the report. The motion carried

unanimously. The Board took the following actions:

1. C.L. Nuss asked questions concerning who has authority to prescribe the ElectroMedical

Wellness Pro Machine to patients. The Board responded this must be prescribed by a

licensed physician.

2. Brian Looby with McGuire Woods Consulting Public Affairs Solutions asks whether

Teledoc violates the Board’s telemedicine. The Board advised to refer to the laws and

rules.

3. Brian Looby emailed with a question – can medical assistants enter physician orders in a

HER? Board replied they may do so, but the physician must sign.

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

Physician must have a license.

5. Affiliated Monitors, Inc. asked the Board to consider inviting them to a Board meeting

for a presentation.. The Board approved the request.

6. Carol Clothier with the American Board of Medical Specialties requested a meeting with

the Board to discuss Maintenance of Certification. The Board requested additional

information.

7. Robert Hull requested if his old orders can be removed from the Board’s website. Board

advised no.

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

only.

9. Rajesh Patel, M.D. had questions. The Board reviewed his letter and advised this is

institution questions and he should refer to the by laws of the institution.

10. Regarding an article entitled “Missouri legislation would allow assistant doctors.” Board

would be apposed to this legislation in Georgia.

Articles Reviewed for Information only;

11. “Experts Discuss 4 Major Barriers to Telehealth Adoption.

12. “Medical Draft Plan to ease Path to Out of State and Online Treatment.”

13. “Decline in Drug Overdose Deaths After State Policy Change.”

14. Letter from the State Board if Workers Compensation – regarding drug screening. Board

responded there should be a complete screening.


MINUTES

JULY 10, 2014

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15. Dana Thomas emailed wanting to clarify that a medical assistant can do B12 shots. Board

advised yes as in the Laws and Rules.

Dr. White motioned to go into closed Session to discuss investigative matters. Dr. Weil seconded

the motion and it carried unanimously.

Dr. Retterbush declared the meeting in Open Session

LAW ENFORCEMENT ACTION REPORT

Emmalie Kirkland, Acting Director of Investigations, presented the Law Enforcement Action

Report for the Board’s review. Dr. Deloach submitted a motion, seconded by Dr. Gross, to accept

the report. The motion carried unanimously. The Board took the following actions:

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

Protection Unit requests certified copies of disciplinary information regarding investigative

file 20140684. Board denied request.

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

Homeowner Protection Unit for certified copies of disciplinary information regarding

Investigative files 20131631, 20101001, 2050912. Board denied request.


Protection Unit for certified copies of disciplinary information regarding investigative file

20130093. Board approved to share information.


Protection Unit for certified copies of disciplinary information regarding investigative file

20140703. Board approved to share information.

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

and/or portions thereof. Board denied request.

6. Request from Sirce Owen, Assistant Chief Counsel of Immigration & Customs Enforcement

(Atlanta Office) for the Board to release J.A.M. application file, and information that he may

have submitted to the Board related to his immigration status or country of citizenship.

Board approved request.

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

Board denied request.

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

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


MINUTES

JULY 10, 2014

4

9. Lawrence Edward Eppelbaum, M.D. – Board ratified acceptance of Voluntary Surrender.

10. 20121268. – Accepted Agreement not to Practice.

11. Laurin Smith, M.D. – Accept Inactive Status Application and waive fee.

12. Kush Kumar, M.D. – Requested to reopen his investigative file. Board denied request.

13. Susan Mildred Harding, MD - Approved amended Consent Order.

14. Warren M. Weber, M.D. – Approved Consent Order

15. Forsyth County Sheriff’s Office, requested that the Board share investigative information

regarding E.W.H. Board approved request.

16. 20141138. – Accept a Consent Order or application for inactive status upon receipt. If not

received in seven days issue Order of summary Suspension.

APPEARANCE BEFORE THE BOARD

Dr. Seth Pope requested an appearance before the Board for denial of licensure reinstatement. Dr.

Pope gave the Board information concerning steps he had taken toward his reinstatement, and asked

for guidance as to what he needs to do to have his licensure reinstated. The Board members asked

questions.

Dr. White motioned to go into Closed Session to discuss investigative matters. Dr. Powell seconded

the motion and it carried unanimously.

Dr. Retterbush declared Open Session.

Dr Butler motioned to uphold denial of Dr. Pope’s reinstatement, and inform him of pathway that

he would need before reapplying. Dr. Deloach seconded the motion and it carried unanimously.

RECONVENED

Dr. Butler moved to go into Closed Session to conduct Investigative Interviews. Dr. White

seconded, the motion and it carried unanimously.

Dr. Retterbush then declared the meeting would be open session upon completion of the

investigative interviews for the purpose of holding committee meetings.

CALL TO ORDER

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


MINUTES

JULY 10, 2014

5

ADVISORY COMMITTEE REPORTS

ACUPUNCTURE ADVISORY COMMITTEE

Dr. Butler presented the report of the Acupuncture Advisory Committee as a motion. Dr. Powell

seconded the motion, and it carried unanimously. The Board took the following actions:

Accepted Quarterly Reports:

Jennifer Myers

Rebecca Porter

Approved application for Initial Licensure:

Byeong-Su Hyun

Other Business:

Accepted as information - the list of limited licensees and supervisors

LASER ADVISORY COMMITTEE

Dr. Gross presented the Laser Advisory Committee as a motion. Dr. Deloach seconded the motion,

and it carried unanimously. The Board took the following actions:

1. The Board approved the Committee’s request to review the draft laser checklists and application

and provide changes.

2. The Board agreed that once changes are compiled, a special conference call will be held with

the Attorney General’s Office to review the application for additional changes or approval.

PHYSICIAN LICENSING COMMITTEE

Dr. House presented the report of the Physician Licensing Committee as a motion. Dr. Powell


Interviews:

1. Saadatmand, Babak- Approved licensure

2. Sams, John – Approved Licensure

3. Paris, Ray – Approved licensure

Tabled Applications:

1. J.P.

2. B.B.

.

Approved Waiver request:

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

2. Pinkey, Broderick-Approve Request for Petition to Waive Rule 360-2-02


MINUTES

JULY 10, 2014

6

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

Rule 360-2-.02(5).

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

school transcript

Approved Residency Training Permits:

Waterman, Jennifer

Kisselberg, James

Boren, Kyle

Green, Brandon

Ghattas, Paul

Butler, Leroy

Barton, Darren

Approved Reinstatement Applications:

33802 Branson, Bernard MD

21654 Brownstein, Richard MD

12440 Cohen, Jack MD

54997 Dobak, William DO

36724 Ebba, Ebba MD

66291 Fowler, Donald MD

57366 Fynes, Margaret MD

42046 Gitter, Morris MD

23480 Miller, Charles MD

55862 Mohsin, Intikhab MD

17106 Kessler, Michael MD

50541 Moore, Keith MD

4673 Vasconez, Luis MD

35336 Avi, Xavier MD

27250S Mith, Joseph R MD

Other Business:

1. Wang, Ya-Ying - Deny Request for USMLE sponsorship

2. Smith, Ronald -Deny Request for USMLE sponsorship

3. Question: Does the Board require a notarized copy of a medical school diploma from an

international medical school graduate if they have provided a verifiable copy of their

transcript? Answer: Yes

4. Rondon Vidal, Michael—Approved one additional month to complete application and

present to the board by the August 7th-8th Meeting.

5. P.K. – Advised will need clinical skills assessment.

6. Laborde, David – Approved request for Administrative License

7. R.R.—Complete CPEP recommended remediation & complete CSA before the board will

reconsider

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


MINUTES

JULY 10, 2014

7

Approved Applicants for Licensure:

72304 OHENE ADJEI, RITA MD

72305 OBASI, IKENNA EREM MD

72306 JONES, ERICA MD

72307 KASIAH, FATIMA ELIZABETH MD

72308 NELSON, ROGER F MD

72309 KERR, PAUL C MD

72310 JIN, QUANRI MD

72311 MADUOMA, CHRISTIAN MD

72312 KAKARALA, PRAMOD MD

72313 ORTIZ-POMALES, YAN T MD

72314 HINRICHS, BENJAMIN HEYE MD

72315 HARRIS, KATHRYN E MD

72316 IP, ANDREW MD

72317 MCKINNON, ELIZABETH ANN MD

72318 MANAHAN, KELLY MD

72319 MCELROY, SAMUEL DAVID PATRICK MD

72320 KILLELEA, ALISON GIULIA MD

72321 LEE, GOO MD

72322 KHAN, SAJID MD

72323 MYERS, TERESA ANN MD

72324 KRAHNKE, JASON STANLEY DO

72325 HUTCHINSON, HANK L MD

72326 NELKOVSKI, LIDIA MD

72327 JASPER, ALAN LAWRENCE RUSSELL DO

72328 HIGHSTEAD, RICHARD GRANT MD

72329 MALCOM, CHRISTOPHER JAMES MD

72330 HAMMONDS, KARON NACHELLE MD

72331 JAGODZINSKI, JASON EDWARD MD

72332 LEON - HERNANDEZ, ANGELA PATRICIA MD

72333 MILLS, KYLE CHARLES MD

72334 JOHNSON, ROBERT PAUL MD

72335 OLSEN, JESSICA MD

72336 NEAL, DURWOOD EARNEST JR MD

72337 KNEER, LEE MICHAEL MD

72338 MOMA, CLETUS TANWI MD

72339 KALARICKAL, PHILIP LUKE MD

72340 MATHEW, KAVITHA ANNA MD

72341 MARINCA, DEBORAH MD

72342 JENSEN, SHARONE MD

72343 KOCH, GREGORY DANIEL MD

72344 KAMEL, IHAB ROUSHDY MD

72345 MEESALA, YASODA MD


MINUTES

JULY 10, 2014

8

72346 KIERAN, OWEN ROBERT DO

72347 LUCAS, MANDY MD

72348 HIRO, MATTHEW EDWARD MD

72349 HERR, RAYMOND KARL MD

72350 KHAN, SHEEMA MD

72351 NYSHADHAM, SOUMYA MD

72352 HALL, PATRICIA FAULKNER MD

72353 HAW, JEEHEA SONYA MD

72354 KASTELLO, ANDREW DOUGLAS MD

72355 KOTWAL, NEVILLE HOMI MD

72356 HOFFMANN, JOHN F MD

72357 HOLTON, JENNIFER ELIZABETH MD

72358 NWOBU, CHINYELU OBIAMAKA MD

72359 KOTLYAR, SIMON MD

72360 KRUSZEWSKI, PATRICE GENEVIEVE DO

72361 HABET, GISELLE K MD

72362 MENDEL, JUSTIN BRETT MD

72363 MOURAD, WALEED FOUAD ELSAYED MD

72364 LIEBERMAN, CAROLE ILENE MD

72365 HART, CRAIG FRANKLIN MD

72366 HARROM, HEATH MD

72367 NAUJOKAS, AGNE DO

72368 ONUEGBU, PATRICIA CHINYERE MD

72369 LAWRENCE, MELISSA MARIE DO

72370 HSU, WILLIAM MD

72371 KOWENSKI, JACOB MD

72372 KARWOWSKI, ELIZABETH WOZNIAK MD

72373 MUBARAK ALI, FARAH MD

72374 KRAFT, MICHAEL CHRISTOPHER MD

72375 MOHAMMED, MUNEERUDDIN QUADIR MD

72376 JOSEPH, LINU CHANDY MD

72377 HAWK, ANGELA FISHER MD

72378 NATHAN, SACHEEN MD

72379 OKONGWU, FRANCELLE MD

72380 JAFARIAN, NAZANIN MD

72381 KAGUMBA, ADA ADHIAMBO MD

72382 OYEYINKA, MOYOSOYE MD

72383 MACE, JAMES EMORY JR MD

72384 NTUI-AYUK, GEORGE NTUI MD

72385 LAKE, LEENA MD

72386 MCKINNEY, DAVID LEON JR MD

72387 NEISEN, MELISSA JEANNE MD

72389 LAKE, ANDREW MD

72390 PATEL, AMRISH TARUNKUMAR MD


MINUTES

JULY 10, 2014

9

72391 PATEL, BEJAL MD

72392 PATEL, CHINTAK MD

72393 MOOSA, YUNUS MD

72394 PATEL, DHAVAL D MD

72395 HANKINSON, SCOTT MD

72396 PATEL, DIPAN MD

72397 PATEL, KUNAL PRAVINCHANDRA MD

72398 PATEL, PRITESH MD

72399 PATEL, VAIDEHI MD

72400 ASHFORD, EMILY REBECCA MD

72401 PATEL, YOGESH N MD

72402 HOLMAN, BRITA JEAN MD

72403 JOSEPH, MICHAEL MD

72404 ALI, YUSUF M MD

72405 HORTON, MICHELLE BARBARA DO

72406 ATWATER, RONALD CLINTON JR MD

72407 PELLENBERG, ROD MD

72408 PENA, GABRIELA MD

72409 PETER, RENNY MD

72410 KHALID, MOHAMMAD ATIF MD

72411 ALEXANDER, ERIN T MD

72412 PETERSEN, EMILY ELIZABETH MD

72413 ABATE, MARGARET EDELWEISZ YVONNA ELAINE MD

72414 PETTIFORD, JANINE NICOLE MD

72415 PHILLIPS, WESLEY SCOTT MD

72416 ASSEFA, MESFIN T MD

72417 POLITE, ADRIENNE DO

72418 POTNICK, AARON MD

72419 PORTER, FERNANDO ANTONIO MD

72420 AMODEO, PHILLIP PAUL MD

72421 QUACKENBUSH, MICHAEL IAN DO

72422 ALMOND, MEGAN MD

72423 RAMIREZ, COLIN MD

72424 RANGE, DANIELLE MD

72425 REED, PAMELA SUE MD

72426 REZANIA, DORNA MD

72427 RICE, NICKLAUS TRENT MD

72428 RICHARDS, JINNE NIKI MD

72429 RIDINGS-HESSER, SANDRA LEA MD

72430 ROBINSON, LEDON ANTHONY MD

72431 ROHATGI, SAURABH MD

72432 SHAHEEN, TARIK MD

72433 SHAIKH, ILYAS A MD

72434 SHAKIR, TAAHA MD


MINUTES

JULY 10, 2014

10

72436 SLOCUMB, CLAIRE LISE' MD

72437 BURKMAR, JENNIFER ANNE MD

72438 APPIAH-PIPPIM, JAMES AKWA MD

72439 SMITH, LAMONT CHARLES MD

72440 SOMANI, KARUN SHANKAR MD

72441 AHO, AMBER JOY DO

72442 SOOD, RAJIV DO

72443 AGUWA, UCHENNA DO

72444 ASENSIO-GONZALEZ, JUAN ANTONIO MD

72445 ROHDE, GERT DO

72446 ROSEBROCK, RICHARD MD

72447 ABDUL-KHALEK, RANA MD

72448 SORENSON, SCOTT MD

72449 RUTLEDGE, MICHAEL ROBERDS MD

72450 BUSKIRK, STEVEN J MD

72451 SPEAKS, ALLYSON WELLS MD

72452 SQUIRE, MICHAEL LOUIS MD

72453 STERN, GARY MD

72454 SAEED, ALIYA MD

72455 SWINK, JASON DUKE MD

72456 SZLAM, SARAH MD

72457 SAITO, ANGELA M MD

72458 SAJJA, RATNA MD

72459 UNGER, MICHAEL T MD

72460 BERNHARD, MATTHEW RENAUD MD

72461 UGBAJAH, WINSTON C MD

72462 VAUGHNS, CHRISTOPHER FRANKLIN II MD

72463 SAMS, JOHN CLARK MD

72464 VARKEY, SANTOSH C MD

72465 SAMUEL, SUHAS JOE MD

72466 SANDERS, JOHN PAUL MD

72467 VELAZQUEZ, JUAN G DO

72468 VICTORICA, CARLOS MIGUEL MD

72469 SANSGIRI, RAKHEE KISAN MD

72470 TAGG, WILLIAM MD

72471 VIRANI, ANISHA MD

72473 SARASWAT, AKHIL MD

72474 WABLE, SUMATHI MD

72476 WEBER, JILL MARIE DO

72477 WEEKS, DAVID MICHAEL MD

72478 SAADATMAND, BABAK MD

72479 WEISSHAAR, PAUL HOWARD MD

72480 WELCH, CRYSTAL LAVETTE MD

72481 CLERMONT, MICHELLE PATRICE MD


MINUTES

JULY 10, 2014

11

72482 SAVAGE, BRISTOL YATES MD

72483 WELCH, JAMES W MD

72484 SAVITCHI, ELEONORA MD

72485 WERAGODA, RAMAL MAJINTHA MD

72486 SCHAFER, FERDINAND JOHANNES MD

72487 WETMORE, CYNTHIA MD

72488 TAHA, MAHDI MD

72489 SCHLEIFER, KIETH RANDOLF MD

72490 WHEELER, TYLER HENSON MD

72491 AYER, ROBERT EMERSON MD

72492 THABET, SALIM RIAD MD

72493 SCHREIBER, DONALD MERLE MD

72494 WHEELER, KIMBERLY DO

72495 SCHULENBORG, STEVEN PERRY MD

72496 ADEBAYO, JOLAADE MD

72497 WELTON, SCOTT T MD

72499 TEMPLETON, DAVID W MD

72500 SCHMITT, RICHARD ALAN MD

72501 WOLSKI, MICHAL J MD

72502 APPLEWHAITE, JANELLE MAUREEN MD

72503 WILLIAMS, LAURA GOWDER MD

72504 THOMAS, ANIL OOMMEN MD

72505 ARAIN, HUMA MD

72506 THOMAS, MATTHEW BRADY MD

72507 ANDERSON, STEPHEN MILLEDGE MD

72508 CORNEJO, SANTIAGO MARTIN MD

72509 TSUNG, ANN MD

72510 WHITE, TAMICA EVELYN MD

72511 WILLIAMS-THOMAS, KAMEISHA TENILE MD

72512 WONG, ALEXANDER WYMAN MD

72513 WYMAN, ANDREW JAMES MD

72514 YUN, SUNG RAK MD

72516 YEHNERT, HANS MD

72517 CHAN, DANIEL STEVEN MD

72518 BREUER, ANTHONY CARL MD

72519 YEOH, JIN SOON MD

72520 COLOVOS, NICK EDWARD MD

72521 ZIA, SUBAILA MD

72522 FOSTER, JAMES GRANBERY III MD

72523 BERGER, STEPHEN MD

72524 CHANDLER, ANNA RUTH MD

72525 CHISM, DAVID DEWAYNE MD

72526 CORBIN, DINA ZEKI MD


MINUTES

JULY 10, 2014

12

72527 DOYLE, JOHN JOESPH MD

72529 FRANKLIN, ALLISON JANE DO

72530 DE JESUS, DANTE VELASQUEZ MD

72531 FALLIERAS, GEORGE NICHOLAS MD

72532 FLOYD, WALTER GRADY MD

72534 BARCHIE, MATTHEW FREDERICK MD

72535 FOSTER, TANJA JORDAN MD

72536 BERGAN, BRANDON RICHARD MD

72538 BROWN-JOHNSON, AMIRAH MD

72539 FERNANDEZ, ELVA ELIZABETH MD

72540 DESAI, NEIL KISHOR MD

72541 FASANO, REBECCA ELLEN MD

72542 BECHTEL, PETER MD

72543 DAVIS, GAVIN WADE MD

72544 DE FREITAS HERNANDEZ, JOHELIN FATIMA MD

72545 GEYER, DENNIS JAMES MD

72546 BERAUER, JOHN-PAUL MD

72547 FRAZIER, ALKETAH ROCHELL MD

72548 ALEMOZAFFAR, MEHRDAD MD

72549 GILLIS, DANNY JAMES MD

72550 BOOMSAAD, ZACKARY ELIAS MD

72551 DANGARIA, HARSH MD

72552 CHU, KAI-CHENG CARRIE MD

72553 GLUTH, AARON DAVID MD

72554 FELICIANO, CARLOS ERIC MD

72555 BARRERA, NOELLEMARIE ANTONIA DO

72556 GOWRAVARAM, SRIDEVI MD

72557 DOGAN-BAG, VAHIDE MERIH MD

72559 GARZA, JUAN JR MD

72560 BURGER, REBECCA KRISS MD

72561 CAMPBELL-BAYAAN, EVELYN MD

72562 DURAN, MARC ANTHONY MD

72563 GEISLER, JOHN PATRICK MD

72564 DAVIS, JONATHAN MD

72565 CHAMPION, HUNTER C SR MD

72566 CUBE, CESAR PADUA MD

72568 ELLIS, SHANNON MD

72569 CURRY, ALECIA ELAINE MD

72570 CAMERON, CRAIG DUNWODY DO

72571 BHATTI, SADAF FAISAL MD

72573 EWOH, CHARLES EGBO MD

72575 ELSAYED, TAMER M MD

72576 FEWLASS, DARIUS MD


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13

72578 GUYTON, FINDA LEE MD

72579 FOWBLE, COLEMAN DEANE MD

72580 FASANO, ROSS MARTIN MD

72581 BHATT, DARSHNA C DO

72582 LABORDE, DAVID VALENTINE MD

72583 MITTER, NANHI MD

72584 VELAYUDAM, KOHILAVANI MD

72585 ONUIGBO, NWAMAKA MITCHELLE MD

72586 SAFDAR, NABILE M MD

72587 PATEL, JAYMIN MANU MD

72588 SHARMA, VIBHASH DINESH MD

72589 GADLIN, SCOTTY LANE MD

72590 ROBERTS, RICHARD LOWELL MD

72591 TRIGG, STEVEN DEAN MD

72592 PAVASIA, NIRAV MD

72593 YAO, ANNIE MD

PAIN CLINIC ADVISORY COMMITTEE

Dr. Weil presented the report of the Pain Clinic Advisory Committee as a motion. Dr. Butler

seconded the motion, and it carried unanimously.

Approved Applications:

1. DaVinci Medical Arts

2. My Pain Clinic

3. The Nexus Pain Center of Columbus

4. Southern Spine & Pain Institute – 3 locations

5. The Pain Specialist

Other Business:

1. Approved Clinics to change their Name:

1. Southeast Spine and Rehabilitation

2. Shefa Pain Consultants

2. Approved Request to transfer ownership - United Pain and Wellness of NE GA

Alvis Perry, MD to William Hill, MD

3. Approved Request to change Location:

Physician Pain Care

My FamilyDoc

4. Approved requests to add two APRNs and one Physician Assistant for Southeast Spine and

Rehabilitation:

Monica McGowan, APRN,

Brandi Gladden, APRN

Diane Metzger-Commisso, Physician Assistant.


MINUTES

JULY 10, 2014

14

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

John Smith, Physician Assistant

Torre Northcutt, APRN

6. Approved request to delete practicing physician:

The Hemlock Pain Center ‐ James Boutselis

7. Approved request to add an APRN to the Athens and Gainesville locations:

Spine Care and Pain Management – Andrea Mealor

8. Approved request to add two physician assistants:

The Nexus Pain Center of Albany, Evans and Milledgeville, GA

1. Dustin Walsh – Albany location

2. Anthony Palazzo – Evans location

9. Approved request to add the following practicing physicians to the Nexus Pain Center:

1. Sandeep Datta – Evans

2. William Hammonds – Evans

3. Oluchi Ozumba - Evans

4. William Hammonds - Milledgeville

10. Approved request from Gainesville Pain Management to change the hours of the following

practicing physician: Janet Griffin, DO

11. S.P.C. – Refer for consent order.

12. Approved request from Shefa Pain Consultants to add the following practitioners to the pain

clinics:

1. Mark Britton, MD

2. Jacob Ward, MD

3. Rebecca Hurd – APRN

4. Kim Naab – APRN

13. Table request from S.P.C. to add the following practitioners to the pain clinics.

1. C.T. MD

2. L.H., MD

14. Approved Committee recommendation to lapse all pain clinic applications that are not

complete and over six months old. For pain clinic applications that are over six months old

but have pending investigations, these applications are to remain as applications in process.

15. Advise Dr. Kroll that in order to have a pain clinic, he must have a physical location.

PHYSICIAN ASSISTANT ADVISORY COMMITTEE

Dr. Antalis presented the report of the Physician Assistant Advisory Committee with amendments

as a motion. Dr. Powell seconded the motion, and it carried unanimously.

The Board took the following actions:

Approved Applicants pending Supervising Physicians:

1. LIS, TADECHER N

2. GODBOULDT, BEATRICE L

3. VADRIA, ANITA KHUSHBU


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Approved the following requests for additional duties: Physician Assistant License# Supervising Physician License# 1. BUSH, VENITA JOY 6087 PERRY, JOHN THEODORE 27421

Dialysis catheter placement and replacement

2. BRESSLER, SUZANNE S 3930 REDDY, PRAVEEN C 56471

CT-guided bone marrow biopsy and aspiration Lumbar puncture

3. DANIELS, CARA 7031 PENDEM, SHANTHAN 68271 Arterial line insertion

Endotracheal tube intubation

4. FRIEDMAN, MATTHEW 7111 PENDEM, SHANTHAN 68271

Arterial line insertion Endotracheal tube intubation

Central venous line placement

5. GILLIS, JAMIE ANN 1923 DESAI, AASHISH KIRAN 52165

Arterial line placement

Chandler pacing probe insertion

Chest tube insertion

Intubation

Swan-Ganz Catheter placement

Thoracentesis

Triple Lumen Catheter insertion

6. HOLMES, KATLYN SUZANNE 6672 JOHNSTON, KIM WALDEN 24443

Lumbar drain / lumbar puncture

7. JOHNSON, DAVID ALAN 6863 KANG, BRANDON SANG JOON 54764

PICC line insertion

8. NORRIS, KENNETH L 2268 HARVEY, RICHARD LYNN 37827

Arterial line insertion

Central line insertion

Pulmonary artery catheter placement

Temporary pacemaker wire insertion and removal

Radial artery harvest

Chest tube insertion and removal

Saphenous vein harvest

Surgical chest closure

9. TRAN, QUYNH 7106 PENDEM, SHANTHAN 68271

Arterial line insertion

Central line insertion

10. WOOD, ZACHARY THOMAS 7125 DEGRYSE, AMBER LEE 65537

Central venous catheter placement

Tabled the following additional duties request for more information:

1. C.D.

2. C.D.L.


MINUTES

JULY 10, 2014

16

Tabled the following application for additional information

1. M.D.

2. T.E.

3. B.G.

4. A.K.V.

Approved the following applications to add/change supervising physicians:

Physician Assistant Lic# Supervising Physician Lic# AHMADI, SHALYN BENAE 3389 SYROP, TAMA LYNN 43135

ARNETT, BRITTANY CARD 6422 FINDLEY, AMBROUS OLIVER JR 28267

AYERS, DANIEL T 2591 PISARELLO, JORGE 58914

BIGGS, BURKETT DONALD 506 PATEL, GAURAV PRAVIN 67305

BLEAKLEY, ELIZABETH 6700 DE LURGIO, DAVID BOWERS 40045

BOLING, CHARLES WAYNE 3551 GRANT, JESSE RAY JR 21510

BOOTH, BERTA ELENA 5897 BARLOW, JAMES B 30717

BOSTIC, KENNETH 3528 HOLTZCLAW, JAMES FREDERICK 35906

BOSWELL, DENNIS HOYT 2742 HAYNES, GAYE NICOLE 49696

BOSWELL, DENNIS HOYT 2742 LOVVORN, JUSTIN DALE 62249

BOUTSELIS, JAMES ANGELO 1535 KEOMAHATHAI, SACKDINANH N 51054

BOWDEN, TODD ARRINGTON 5127 HALLOWES, WILLIAM 35893

BRAND, KEMPER MARION 6237 KOHLI, HIRA 60290

BROCK, GINA MARIE 7168 WAZEERUD-DIN, SULIEMAN A 60891

BROCK, HEATHER SUZANNE 3270 FERRELL, THOMAS JR 8433

BROWN, LINDSEY AUSTIN 6239 DONNELLY, CASSANDRA B 68144

BURDETSKY, MARGARITA G 3622 VANN, JODI WOLFE 41988

BURKE, GREGORY LANIER 2771 KETCHEY, CHRISTOPHER C 63875

BURKE, TRACY FOSSAS 6353 HORNSBY, JAMES LARRY JR 54389

CASANOVA, PEDRO 2333 BURRESS, THOMAS 67539

CAVINESS, STEPHANIE

GREATHOUSE

6430 WOODHALL, DANA 66843

CHAPPUIS, RICK ALAN 3558 MARTINO, JOSEPH ANTHONY JR 37023

CHOKSY, VAIRAGI 7145 AUSTIN, JACK HULON JR 32689

CLARK, AMANDA 6480 DALTON, BOOKER HUGHES 35608

COOPER, MARY LANE 1586 GARDNER, ALETA M 46851

CROSBY, STEPHEN B 5461 SHERWOOD, BOZEMAN K 26379

CROUCH, ROBERT JOSEPH III 6426 ANTHONY, CLEMENT REESE 27752

DAVENPORT, LISA ZAMMIT 3468 RIVES, PETER ANDREY 61646

DEAN, ALAN B 1540 KEEFE, BRIAN THOMAS 37587

DEBRAGGA, STEPHANIE KURTZ 6729 BERNAL, LEON 57283

DEV, JASMINDER SINGH 5853 OPARE, NANA KWAKU 58113

DLUGOS, DINA ELLEN 3394 MA, GRACE YU-CHUN 47345

DOVIE, ERIKA 4281 GOTTSCHALK, JENNIFER C 62991

DUANE, PRESCOTT BOWERS 2892 CLARK, KUDIRATU A 69565

EARNHART, MARIA M 5628 LEE, EDWARD 43681


MINUTES

JULY 10, 2014

17

Physician Assistant Lic# Supervising Physician Lic# EASON, JESSE BLAIR 6090 DAVENPORT, JEFFREY PATON 63574

ESHLEMAN, BRANDON LEE 6606 ELLIOTT, LA-SHAUN DENISE 68404

FELDER, MARTHA 6978 KING, ROBERT EDWARD 53835

FINLEY, HEATHER LOUISE 2462 MAGUIRE, RICHARD ROBERT 58278

FISHER, GREGORY LEE 2916 PARROTT, MAXWELL 45574

FISHER, GREGORY LEE 2916 TAPLEY, CHARLES LEON 53712

FLETCHER, ANNA H 6909 SCHINELLI, ANTHONY 37362

FORT, KEITH WESLEY 6400 SUTPHEN, SUSSAN KAYE 37396

GARRISON, LINDSEY ANN 6657 TALLEY, ROY LAMAR JR 29957

GBADAMOSI, AHMED O 6071 RICHARDSON, EDDIE JR 52047

GIDDENS, SHANE LEON 5490 POWERS, JOSEPH MATTHEW 69933

GONZALEZ, ANNIE MARIE 7189 OSHINOWO, ABAYOMI G 43447

GORRA, VALERIE 7050 CURRIER, STEVEN JAMES 65231

GREEN, MARK STEPHEN 2321 DAVENPORT, JEFFREY PATON 63574

GRILLO, BRUNO JOHN 4809 SHEIKH, ABDUL MALIK 52017

GUNDER, SHAWN E 2919 PARFENCHUCK, THOMAS ALAN 39651

GUTIERREZ-CARDI, RACHEL ANN 6489 BELLAMY, MICHAEL ALLEN 70530

HAYNES, JONATHAN 7073 FYE, CHIQUITA AGATHA 20707

HEDRICK, JAMES ELBERT 3729 ESPETIA, OSCAR DAVID 65358

HENNEK, KRISTIN KYLE 7170 GRANGER, JAMES ROCHESTER III 55824

HERRING, TONI LYNN 6360 JAMES, RICHARD PEELE JR 49455

HOLLAND, JANET L. 3013 MCBRAYER, DANIEL ENOCH 18697

HOWARD, THOMAS AUSTIN 4631 ANGEL, JOSE FERNANDO 17360

HUTCHESON, TROY EUGENE 4831 TAYLOR, EARLE MCRAE 25298

HUYGHUE, YOLANDA MARIE 4011 BURKE, RACHEL DAMARIS 66997

ITACY, RAYLLENSONS 6147 GRUPKA, MICHAEL JORDAN 60588

JACKSON, REBECCA DOTT 5467 EISENBERG, STEVEN JAY 36146

JACKSON, REBECCA DOTT 5467 NGUYEN, ELIZABETH THUY N 55682

JACQUET, NELSON 4350 CHENG, ALAN CHUNG-KEE 66271

JEAN-JACQUES, EMMANUEL 5535 BARRETT, CAROL ANNE 70044

JEAN-JACQUES, EMMANUEL 5535 OLIGA, JEANINE BARKER 49363

JEFFERSON, ANDREVIUS T 4496 MCLENDON, KENNON ALLEN 33393

JENNINGS, DONNA FAYE 6577 SCHUH, MARTHA BLACKWELL 37488

KNORR, PATRICK RYAN 6434 REHMAN, OBAID 44990

KRUPANSKY, CRAIG 7093 RICE, KENNETH MACLEOD 47251

LANDERS, PAMELA BRITT 1795 DAUPHIN, BRIDGET ANTOINETTE 55199

LEWIS, CHAD EDWARD 5094 PATEL, JITESH VINOD 65869

LIBBY, ALICIA 6182 SPURLOCK, RICK JR 59207

LINDSAY, KIMBERLY KATHRYN 6388 MONTANA, SUZANA MARA 45097

LOGAN, SHARON COFFIELD 4536 PATEL, TARAK VIPINCHANDRA 66394

MATUZA, CHARLES 1433 GOTTSCHALK, JENNIFER C 62991

MCCARTHY, DANIEL JOSEPH 5280 REDD, DOUGLAS CHARLES 32463

MILLER, KELLY H 6862 DALVI, ANANT G 63849


MINUTES

JULY 10, 2014

18

Physician Assistant Lic# Supervising Physician Lic# MOORE, CHASKA LASHAWN 4012 CHOI, JONG JIN 52043

MORRIS, KIAN 7079 REAMES, DAVIS 72096

MOUGHAMIAN, DENICE LOUISE 2616 BERGERON, RHET LEON 44683

MUELLER, MEGAN DOWDY 6014 CASTRESANA, MANUEL RAMON 22729

NORTON, SARAH ELLEN 6101 WU, CHANGCHUN 61537

ORCIUCH, NIKKI 6321 DOUCHY, CHARLES JACOB 66516

ORTEGA, OMAR 6996 KANYE, WILLIS 64699

PAN, YA-PING 1973 ERCEG, STEFAN KENNETH 64371

RADCLIFF, SANDRA LOUISE 6793 ESTARIS, JOVITO BUADA 22544

REILLY, EDWARD 4794 SMITH, GARY 10666

RHOADES, ADAM N 7080 KABBANI, AZMI 31171

ROBERTS, HANNAH 5051 HOUSE, JOHN CLIFFORD 11959

ROBINSON, TERRY LYNN 3629 OSHIYOYE, ADEKULE E 70219

ROCI, MORGAN 7104 ELLENOFF, BONNIE POLLOCK 51644

SARTORI, JAMES H 2380 JHEE, THOMAS SEUNGNAM 20447

SATCHELL, TIFFANY MELISSA 5145 JAMES, TIENCIA DOROTHEA 58882

SAWYER, JEWEL 6190 POAG, JOYCE HOUSTON 21355

SCOGGINS, BRETT RAYE 2841 ERCEG, STEFAN KENNETH 64371

SEN, CRYSTAL CLARK 5269 PEPPER, KARA JEHLE 59847

SHAH, NITI 7004 MADU, APRIL 66175

SHEARER, GWENDOLYN 6895 KARIM, YASMIN KHADIJA 66194

SHEPS, MARYANN CHRISTINE 7169 BAKER-BROWN, JUDIETH E 36090

SIMMS, JOHN EDWIN 1266 ROBERTS, MARCUS CARROLL 35986

SMITH, AMANDA HEATHER 5444 ERCEG, STEFAN KENNETH 64371

SPENCER, JASON C 3768 THOMPSON, ALBERT MARION JR 22338

SULLIVAN, SAMANTHA 7141 SHKLYAR, BORIS 65180

SUMMER, BEN 7162 DUCHYNSKI, MICHAEL PATRICK 71336

SUPRUNIUK, IRINA 3613 OUDERKIRK, JOHN PHILLIP 49992

SYED, SEEMIE NAZ 5510 SWAMI, RAJENDRA VIPIN 30226

TAYLOR, ANTHONY KEITH 4325 BARNARD, HENRY HARRIS II 37961

TAYLOR, KRISTIN S 6019 MEIER, EDWARD 43426

THOMAS, REBEKAH EVELYN 6585 TATA, UDAY KUMAR 53413

TILTON, LORI YOUNG 4326 D'ANNA, FRANK JOSEPH 36952

TOMAN, AMBER LEIGH 5452 LAM, JASON CHUN SANG 60528

VAUGHNS, RABIA LYNNE 5609 BLAKE, BRYAN DAVID 40613

VON DER SCHULENBURG,

AMANDA

3997 MA, GRACE YU-CHUN 47345

VON DER SCHULENBURG,

AMANDA

3997 WANG, THERESA 70000

WEEKS, MORGANNE MELISSA 6807 RIVES, PETER ANDREY 61646

WEINISCH, ERIN KIM 6109 HARTMAN, MICHAEL GLENN 33350

WILSON, CHARICE JORDAN 6661 ODETOYINBO, ADEDAPO O 55829

WOLFF, WILLIAM H 1042 MERCHEN, TODD 58986


MINUTES

JULY 10, 2014

19

Physician Assistant Lic# Supervising Physician Lic# ZUNDEL, SHANNON DAWN 5735 FONG, PETER EDWARD 56467

Approved the following initial applications for licensure:

Physician Assistant File# Supervising Physician License#

ABNEY, DAVID H 6226 BARLOW, JAMES B 30717

ANDERSON, NATE EDWARD 6260 ILLSTON, BLAKE JEFFREY 68035

BAER, CHELSEA MARTHAN 6254 ROSS, CHARLES BRIEN 68549

BALDWIN, PATRICIA F 6217 ROGERS, JOHN JAMES 21040

BLANKS, BENJAMIN P 6259 LEE, GREGORY PRICE 48121

BROWN, MELISSA RENEE 62257 TRINH, HAI HONG 55991

CARLSON, CATHERINE ANN 6255 THANKACHAN JACOB, ARUN 69981

CHAUSSINAND, DANIELLE M 6270 KAVALI, CARMEN MICHELLE 50968

CHEN, YUEGANG 6195 HOOTS, ANTHONY VON 33114

COLEBURN, NATASHA C 6161 MADUKA, YVONNE M 64804

DALY, MEGAN 6250 OLIVER, DAVID STEVEN 38323

DIPRIMA, KIMBERLY 6233 WILKES, JOSEPH SHEPPARD 21442

ELLIS, JASMINA LEIGH 6228 MURRAY, STUART WILSON 31080

FOUNTAIN, KATIE 6223 KEEFE, BRIAN THOMAS 37587

GARCIA, SHAWN DWAYNE 6137 SYMBAS, NIKOLAS PETER 42127

HENLEY, SAMANTHA 6241 CANNON, CLIFTON L III 59051

HEWIT, LEANNE PATRICIA 6256 CARR, FELICIA GLORIA 28190

HOOKS, DELAINA MARIE 6272 KHANSARINIA, SAEID 50649

HOWARD, MANDI 6187 BOYCE, BRANDON MARK 67392

JONES, STACIA WOOD 6194 BISHOP, RANDOLPH COURTNEY 41516

KRIEGER, CAITLIN E 6234 RICHARDSON, EDDIE JR 52047

LEE, JULIA SANG-MI 6224 SPITZLER, SUSAN RUDNICKI 45342

MCELVEEN, VICTORIA C 6243 BRUCE, BRANDON 71050

MELTON, JEREMY DANIEL 6221 TERRELL, WILLIAM DEAN 41688

MOHAN, LAURA 6227 KINAHAN, JAMES JOSEPH 32577

MORELAND, WHITNEY 6229 HENRY, HEATHER A 44231

MUSILLE, ROSE M 6248 RAJAGOPAL, VIVEK 59318

OLISE, PATRICK O 6237 DALVI, ANANT G 63849

PATEL, NIRALI D 6232 MURRAY, STUART WILSON 31080

PHILIP, STACEY 6244 PRIDE, YURI BERNARD 69617

PIETRANGELO, LISA 6249 STEPHENS, CHARLES RAY 58785

RIVAS, RODOLFO ORESTES 6193 VELASQUEZ, JONATHAN 48581

SMITH, ERIKA HARVEY 6225 PARRISH, WILLIAM ELIJAH 47989

SMITH-WILLIAMS, JENNIFER 6265 CADIER, THOMAS ROCHE 16320

STANLEY, JULIA ANNE 6252 GREY- MCBRIDE, MONIQUE 71236

VIAR, BRITTNEY 6258 KIM, ELI YONG 70656

WADE, CHRISTOPHER 6213 BURRESS, THOMAS 67539

WASSON, JESSICA LEIGH 6158 NICOME, NICOLE K 60133

WHATLEY, PETER BIRAM 6242 JEFFORDS, KELLAND K JR 49041


MINUTES

JULY 10, 2014

20

Physician Assistant File# Supervising Physician License#

WILSON, DORICE REENA 5490 HATMAKER, DAVID LARRY 26300

WILSON, VIRGINIA 6240 ROSS, MARY KAY 55437

WOOLSEY, CHERYL ANNE 6132 DICKHAUS, DELLICE MARIE 61842

WITSIEPE, KARA NISBET 6239 DAVIS-MITCHELL, WENDY 45442

WRIGHT, RENEE THERESE 6251 MA, GRACE YU-CHUN 47345

Other Business:

1. The Board clarified that when physician assistants request the Board’s approval for

additional duties that the Board has approved them to perform under other supervising

physicians, the PA is not required to provide case logs to demonstrate competency.

2. E. C. - Rescinded licensee’s ANTP with Board; Required 240 hours of supervised practice;

Required 4 quarterly reports from supervising physician; Required CME logs for the time

the licensee was out of practice.

3. E. L. - Accepted update from PHP

4. Morris, Timothy Alan (1386) - Accepted documentation of licensee’s completion of Board-

ordered supervised practice; Lifted consent order requiring supervised practice

5. C. W. - Accepted update from PHP

RESPIRATORY CARE ADVISORY COMMITTEE

Ms. McGarity presented the report of the Respiratory Care Advisory Committee as a motion. Dr.

White seconded the motion, and it carried unanimously. The Board took the following actions:

Approved Applicants requesting 12-month permits: Florida A&M University

1. Johnson, Tamickqa

Georgia State University

1. Lee, Travis

Lake Superior College

1. Cogswell, Desirae

Middle Georgia State College

1. Claggion, Morgan

2. Everson, Jennifer

3. Fogarty, Carlton

4. Sheffield, Gloria

Southern University

1. Howard, Erika

South West Community College

1. Moody, Amanda


MINUTES

JULY 10, 2014

21

Approved Applicants by Reciprocity:

1. Badou, Luzette – pending additional information

2. Brown, Delori

3. Dennis, Kim – pending additional information

4. Dobbins, Lori

5. Gamez, Lina

6. George, Lali

7. Joseph, George

8. Ousley, Herman – pending additional information

9. Park, Chimene

10. Vincent, Jaysen

Approved Applicants for Reinstatement: 1. Ekler, – pending additional information

2. Garnett, George – pending additional information

3. Linch, Lessie

4. Ray, Marilyn – pending additional information

5. Smith, Christie – pending additional information

6. Staystork, Charlene

Approved Applicants for Permanent licensure

1. Nezat, Shelli

2. Romiluyi, Omotayo


1. Bellfleur, Annie

2. Fambro, Michelle

3. Hurkes, Shanice

4. Lott, Marcus Jr.

5. Louis-Charles, Viola

6. Pierre, Anslem

7. Sisco, Evelyn

8. Tesfu, Mahlet

ADVANCED PRACTICE NURSE ADVISORY COMMITTEE

Dr. House presented the report of the amended APRN Advisory Committee as a motion. Dr.

Deloach seconded the motion, and it carried unanimously. The Board took the following actions:

The following protocol agreements meet the provisions of OCGA 43-34-25:

APRN DELEGATING PHYSICIAN

Abramson, Cara Dubovsky, Daniel MD

Akins, Kathy Brantley, David MD

Asa, Michelle Hopkins, Alicia DO

Atkins, Bethany Turfler, David MD


MINUTES

JULY 10, 2014

22

Banister, Anna Laygo, Romualdo MD

Banner, Laura Blevins, Shaena MD

Barco, Angela Sherwood, Bozeman MD

Barlow, Paula Gwathney, Miriam DO

Bentley, Melissa Vermeer, Todd MD

Black, Tekesa Montaque Jr., Freeman. MD

Botero, John Adisa, Wasiu DO

Brown, Darlene Price, James MD

Brueshaber, John Nikolinakos, Petros MD

Byers, Ann Blevins, Shaena MD

Caldwell, Cindy Smith, Kevin MD

Callahan, Kimberly Spencer, Dennis DO

Chabot, Judith Outz, Charles MD

Clark, Tiffany Martin, Garland MD

Coleman, Kelly Marler, Robert MD

Comer, Judith Dawis, Jeffrey MD

Cooper, Layla Wyatt, David MD

Crandall, Lisa Parikh, Naresh MD

Creed, Tracy Sumandeep, Sangha MD

Curtis, Tommy Moss, Kelvin MD

Dada, Oasumbo Subich, Davis MD

Davis, Michelle Hoots, Anthony MD

Dees, Latasha Rubin, Mitzi MD

Denly, Gregory Espetia, Oscar MD

Faudree, Cyndi Bailey Jr., Marion MD

Floyd, Linda Rasalam, Livingston MD

Folds, Hannah Francis, Woody MD

Fowler, David Risby, Emile MD

Frederick, Carlie Risby, Emile MD

Freeman, Christi Weiss, Lawrence MD

Gipson, Tonya Garland, Brenda MD

Gokal, Payal Ghamande, Sharad MD

Gooding, Karen Sumandeep, Sangha MD

Goodman, Erin Hundley, Jonathan MD

Gregory, Shalia Hales, Chadwick MD

Gregory, Shalia Hassar, Ihab MD

Gregory, Shalia Hu, William MD

Gregory, Shalia Lah, James MD

Gregory, Shalia Levey, Allan MD

Gregory, Shalia Krishnankutty, Sathian MD

Hails, Catherine Cooper, William MD

Hall, Koreen Onwuanyi, Ankwe MD

Halvey, Kathleen Hott, Brenda MD

Harrison, Shirley Owens, Crystal MD


MINUTES

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23

Hodnicki, Deanna Deal, Michael MD

Hooker, Tanisha Sumandeep, Sangha MD

Hudson, Virginia Cunnigham, William MD

Hudson-Gallogly, Wanda Danforth, Christine MD

Hughes, Tammy Tehrani, Nasser MD

Hunter, Tamara Hunt, Loren MD

Hurst, Sabine Clearly, Kevin MD

Jewell, Lisa Steele, Collyn MD

Johnson, Courtney McLendon, Kennon MD

Johnson, Mae Voegele, Stanford MD

Jordan, Sarah Kasongo, Mana MD

Kaimachiande, Finda-Mani Rogers, Tosha DO

Kappes, Julia Campbell, Robert MD

Kent, Yolanda Agarwal, Deepali MD

Kiewit, Deura Oreus, Maxcene MD

Kilgore, Catherine Baron, Michael DO

Knudsen, Irina Shin, Dong Md

Langston, Lydia Sogade, Bola MD

Leary, Bridget Sogade, Felix MD

Lee, Cindy Coleman, William MD

Leigh, Stacy Goo, David MD

Lemberg, Robert Dalvi, Anant MD

Ley, Kristen Kumpel, Tiffany MD

Mallory, Edna Roman, Charles DO

Mansfield, Elizabeth Bennett, Garrett MD

Mathis, Stephanie Thomas, Susan MD

McLeod, Melissa Sinclair, James MD

McNeal, Virginia Ajayi, Edward MD

McNulty, Amanda Wilson, Robert MD

Mealor, Andrea Holladay, Janene MD

Medlin, Helen Day, Zenobia MD

Merritt, Marcie Mann, Thomas DO

Meyer, Rebecca Blevins, Shaena MD

Millsap, Lori Battle, Lee MD

Momoh, Isata Hogan, Matthew MD

Morris, Katherine Batlle, Maria MD

Nelson, Christy Hill, Van MD

Nothcutt, Torre Tafor, Stephen MD

O’Flynn, Tamsyn Faulk, David MD

O’Hara, Janet Kornblatt, Brian MD

Obuba, Joseph Burton, Kelvin MD

Okoro, Ngozi Mayfield, Jan MD

Painter, Susan Aleem, Asaf MD

Parker, Sandra Rossi, Peter MD


MINUTES

JULY 10, 2014

24

Penland, Erin Libert, Cynthia MD

Perkins, Gloria Thomas, Susan MD

Peters, Chanya Nesmith, Charles MD

Phillips, Amanda Oddis, Carmine MD

Phillips, Karen Van, David MD

Pickett, Angelique Ward, Bradley MD

Pinyerd, Abby Singh, Amar MD

Pryor, Julie Cooper, Carroll MD

Pryor, Julie Cooper, Carroll MD

Pryor, Julie Gavrikov, Vitaliy MD

Pryor, Julie Gavrikov, Vitaliy MD

Ralph, Amanda Runyan, Thomas MD

Rangnow, Katie Faith, Daniel MD

Reardon, Thomas Ash-Mapp, Nicole MD

Rease, Lashandra David, Dion MD

Rentz, Anna Herrbold, Francis MD

Richardson, Cynthia McLendon Jr., Julian MD

Rinehart, Cynthia Pirani, Safia MD

Rivers, Tammy Harvee, Gulsha MD

Rogers, Candice Dasher, Glen MD

Round, Sally Fazal, Javed MD

Sahatevasukont, Chitchawal Aleem, Asaf MD

Sandord, Sally Rojas, Eduardo MD

Sanford, Sally Evans, Donald MD

Savage, Kimberly Brown, Christopher MD

Shah, Payal Patel, Dhameshkumar MD

Smith, Janet Mayfield, Jan MD

Smith, Melissa Queen, Susan MD

Smith, Melissa Risby, Emile MD

Sparks, Tony Hatmaker, David MD

Standiford, Christen Zottoli, Lawrence MD

Stargell, Elizabeth White, James MD

Stewart, Martha Weinberg, Paul MD

Stout, Mandy Moy, Alan DO

Thackston, Tricia Ash-Mapp, Nicole MD

Thompson, Jennifer McLendon Jr, Julian MD

Trent, Amy Udo, Emem MD

Tripp, Sarah Thakore, Hetal MD

Uba, Helen Morgan, Marla MD

Uba, Sabo Dawson, Angela MD

Wagner, Jaclyn Faith, Daniel MD

Walker, Jenny Dyer, Divina MD

Weinberger, Ellen Smith, Walter DO

White, Dianna Clark, Teresa MD


MINUTES

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White, Rhonda Stevens, Christopher MD

Willard, Karen Houry, Debra MD

Williamson, Ronda Whitlock, Paul MD

Wooley, Kari Delgado, Redan MD

Works, Lesley Flowers, David MD

Yarnell, Richard Middlebrooks, Edward MD

Yelton, Pepita Greaves, Paula MD

The following protocol agreements meet the provisions of OCGA 43-34-25 with additions or

changes:

APRN DELEGATING PHYSICIAN

Becker, Deborah Sial, Rubina MD

Bellamy, Dene Mendoza, Delquis MD

Briggs, Natalie Barlow, Jim MD

Cheeseman, Karen Aleem, Asaf MD

Cochran, Angela Kelly, Scott MD

Crouse, Sharon Davis, Thomas MD

Desandre, Carolynn Danforth, Christine MD

Dobbs, Monica Baldwin, Richard MD

Dressler, Susan Thompson, Teresa MD

Hart, Kimberly Baldwin, Richard MD

Hummel, Mary Danforth, Christine MD

Keller-Vice, Hayley Hong, Gayoung, MD

Lewis, Ellen Katragadda, Suneel MD

Mullis, Laura Taylor, William MD

Randall, Rhonda Captain, Anthony MD

Reynolds, Sharon Varnell, James MD

Story, Heather Franco, Fabian MD

Townsell, Barbara Strickland, Catherine MD

Townsell, Barbara Budlong, Brenda MD

Trachhia, Maureen Blank, Stephen MD

West, Carolyn Martin, Nicolle MD

Other Business:

1. Approved additional procedures for agreement between Dana Petersen & Dr. Jeffrey Peretz.

2. Denied additional procedures for agreement V.R. and S.D., MD. APRN has not completed

training as required by the Board.

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

are required to review and sign a total of 10% of all of the NPs patient records for whom

he/she has delegated prescriptive authority.

4. The Board has no information regarding possible legislation to take effect in 2015 requiring

acute care certification vs. family certification in a hospital setting. Committee will revisit

the subject at the August 2014 meeting.


MINUTES

JULY 10, 2014

26

5. Protocol agreement between C.R. and R.B., MD – physician no longer meets the criteria for

a delegating physician. NP has not submitted a new agreement with a new delegating

physician as required by the Board (June 2014) and is illegally practicing under OCGA 43-

34-25. File will be forwarded to Enforcement.

PERFUSION ADVISORY COMMITTEE

Dr. White presented the report of the Perfusion Advisory Committee as a motion. Mr. Powell


The Board took the following actions.


Sterina Hill

Dale Ruby

Alois Lesch

Emily Sauliti

Other Business:

Reviewed Committee request for clarification on how they would handle a response from an

applicant for initial licensure or renewal that they may not be able to practice with reasonable skill

and safety. Board advised they would review these responses on a case by case basis.

CLOSED MEETING Dr. Deloach made a motion, seconded by Dr. Gross, to go into closed session to discuss pending

litigation, investigative, and Wellness Committee matters. The motion carried unanimously.

OPEN MEETING

Dr. Retterbush declared the meeting in Open Session.

WELLNESS COMMITTEE Dr. Powell presented the report of the Wellness Committee as a motion. Mr. Wallace seconded the

motion, and it carried unanimously. The Board took the following actions:

PHP report received.

1. Julian Gordon, MD- Approve order terminating probation.

2. Robert J. Straub, MD- Approve order terminating probation. (Dr. Grossman recused)

3. Hugh Hall, MD- Table.

4. Case #20091621-Grant request to terminate monitoring.

5. James DeSantis, MD- Deny request.

6. Ronald Trotman, MD- Deny request.

7. Case #20090826. Grant request to terminate monitoring.

8. Jerry G. Purvis, Jr., MD- Table. (Dr. Retterbush, Dr. Deloach, and Dr. Powell recused).

9. Daryl Ellis, MD- Approve order terminating probation.

10. Anthony Securo, MD- Deny request.


MINUTES

JULY 10, 2014

27

Other Business

Discussion of Board lists of facilities approved to conduct evaluations.

INVESTIGATIVE COMMITTEE

Dr. Deloach presented the report of the Investigative Committee as a motion. Dr. Deloach.

seconded the Committee’s motion, and it carried unanimously. The Board took the following

actions:

Recusals:

McGarity: 20141176

Mohan: 20131211 20131212 20131213

DeLoach: 20141201

Retterbush: 20140623 20141179 20141191

Powell: 20140623

Butler: 20141199

House: 20141199

Slappey: 20141199

Close:

20130181 20131212 20131213 20131214 20140696 20140967

20141047 20141049 20141102 20141286 20141373 20141382

20130385 20130764 20131153 20140620 20140700 20140718

20140746 20140747 20140752 20140763 20140769 20140771

20140804 20140815 20140828 20140836 20140837 20140868

20140928 20140929 20140931 20140954 20140965 20140988

20141000 20141004 20141006 20141009 20141011 20141015

20141022 20141025 20141048 20141055 20141064 20141066

20141069 20141071 20141075 20141080 20141082 20141088

20141089 20141098 20141131 20141142 20141145 20141151

20141154 20141174 20141178 20141195 20141200 20141204

20141211 20141216 20141239 20141242 20141243 20141263

20141266 20141270 20141273 20141323 20141339 20141343

20141375 20141380 20141450 20141457 20140998 20141061

20141166

Close with Letter of Concern:

20121502 20130691 20130765 20131753 20140520 20140643

20140995 20141017 20141067 20141084 20141179 20141191

20141260 20141421 20141431 20141551 20141181

Invite for Interview:

20131211 20131533 20140566 20140584 20140885 20141176

20141199


MINUTES

JULY 10, 2014

28

Table:

20140945 20141201 20141598 20121568 20140529

Further Investigation

20140623 20140843 20141569

INITIAL COMPLAINT EVALUATIONS

Close:

20141109 20141289 20121330 20141338 20141340 20141345

20141346 20141348 20141355 20141358 20141360 20141384

20141396 20141397 20141408 20141420 20141437 20141441

20141448 20141455 20141461 20141463 20141464 20141478

20141486 20141487 20141509 20141530 20141540 20141544

20141548 20141549 20141550 20141557 20141566 20141591

20141751 20141503

INVESTIGATIVE INTERVIEW REPORT

1. 20131666 Reschedule

2. 20141501 TABLE

3. 20140818 NO SHOW

4. 20140580 CLOSE

5. 20140528 CLOSE

6. 20131509 CLOSE w/LOC

7. 20131261 TABLE

8. 20131653 & 20140262 CLOSE & Terminate Order

Other business:

9. 20140581 CLOSE

ADJOURNMENT

Dr. House made a motion, seconded by Dr. Powell, to adjourn the July 10, 2014 Board meeting.

The motion carried unanimously. Dr. Retterbush adjourned the meeting.

____________________________ ________________________________

David Retterbush, MD LaSharn Hughes, MBA

Chairperson Executive Director

Recorded by Diane Atkinson

Documents

GEORGIA COMPOSITE MEDICAL BOARD MINUTES JULY 10, …GEORGIA COMPOSITE MEDICAL BOARD MINUTES JULY 10, 2014 1 The Georgia Composite Medical Board (GCMB) held its regular meeting on July