18
HeartCarG ASSOCIATES OF CONNECTICUT, LLC Ricardo F. Cordido, MD 0 Samuel Hahn, MD 0 Siegfried Kra, MD 0 Jack Hauser, MD Alicia Burr, APRN 0 Andrew Rodican, PA 0 Mark Whelan, PA USNRC Region I Licensing Material Section 475 Allendale Road King of Prussia, PA 1 9406- 141 5 September 23,2005 RE: NRC License Amendment Application To whom it may concern: Enclosed is a complete application for an NRC radioactive materials license amendment for our facility. We are currently operating under the authority of NRC license #06-30702-01, through amendment #2, with an expiration date of 2/29/2012. Item #1: tation of Dr. Vulpe’s training and experience in enclosure #l. We wish to add Dr. Marian E. Vulpe as an authorized user. Please find documen- Item #2: cense from Charles Giomuso, MS to Roberta J. Alvarez, CNMT, ARRT. Please find attached in enclosure #2 a letter of recommendation for Mrs. Alvarez from the current Radiation Safety Of- ficer and a transcript of her educational achievements. Please note that Roberta J. Alvarez, CNMT, ARRT was previously known as Roberta J. Thomas, CNMT, ARRT. We wish to train the designation of Radiation Safety Officer from our NRC Li- Item #3: address listed for our East Haven Office. The following is the correct address for this facility: Please note that in amendment #2 of our current NRC License there is an error in 203 Main Street East Haven, CT 065 12 Item #4: (the addition of an interior door and wall). Please find a copy of the modified floor plan in enclo- sure #4 showing the addition of the interior door and wall. This was added to facilitate patient comfort and workflow. There has been a slight modification to the floor plan for our East Haven facility Should you have any questions regarding this application, please feel free to contact me. Sincerely , Enclosures N VI 3 Bella Vista 0 East Haven Hamden 0 Meriden 0 Wallingford West Haven Tel: 203.407.5800 0 Fax: 203.407.5812 0 www.heartcareassoc.com

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Page 1: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

H e a r t C a r G A S S O C I A T E S OF C O N N E C T I C U T , L L C

Ricardo F. Cordido, MD 0 Samuel Hahn, MD 0 Siegfried Kra, MD 0 Jack Hauser, MD Alicia Burr, APRN 0 Andrew Rodican, PA 0 Mark Whelan, PA

USNRC Region I Licensing Material Section 475 Allendale Road King of Prussia, PA 1 9406- 14 1 5

September 23,2005 RE: NRC License Amendment Application

To whom it may concern:

Enclosed is a complete application for an NRC radioactive materials license amendment for our facility. We are currently operating under the authority of NRC license #06-30702-01, through amendment #2, with an expiration date of 2/29/2012.

Item #1: tation of Dr. Vulpe’s training and experience in enclosure #l.

We wish to add Dr. Marian E. Vulpe as an authorized user. Please find documen-

Item #2: cense from Charles Giomuso, MS to Roberta J. Alvarez, CNMT, ARRT. Please find attached in enclosure #2 a letter of recommendation for Mrs. Alvarez from the current Radiation Safety Of- ficer and a transcript of her educational achievements. Please note that Roberta J. Alvarez, CNMT, ARRT was previously known as Roberta J. Thomas, CNMT, ARRT.

We wish to train the designation of Radiation Safety Officer from our NRC Li-

Item #3: address listed for our East Haven Office. The following is the correct address for this facility:

Please note that in amendment #2 of our current NRC License there is an error in

203 Main Street East Haven, CT 065 12

Item #4: (the addition of an interior door and wall). Please find a copy of the modified floor plan in enclo- sure #4 showing the addition of the interior door and wall. This was added to facilitate patient comfort and workflow.

There has been a slight modification to the floor plan for our East Haven facility

Should you have any questions regarding this application, please feel free to contact me.

Sincerely ,

Enclosures

N

VI 3

Bella Vista 0 East Haven Hamden 0 Meriden 0 Wallingford West Haven Tel: 203.407.5800 0 Fax: 203.407.5812 0 www.heartcareassoc.com

Page 2: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

-

University Hospital of St. Luke's-Roorevolt Columbia University College Hospital Center

S t Luke's Division of Physicians & Surgeons 1 1 1 1 Amsterdam Avenue New York, NY 10025

Alan Rozanski, M.D. Professor of Medicine, Columbia University College of Physicians and Surgeons Director, Cardiology Fellowrship Training Program Director, Nuclear Cardiology. St. Luke's-Roosevelt Hospital Center 11 11 Amsterdam Ave New York, NY 10025

May 12,2005

Certification Board of Nuclear Cardiology:

Dr. Marian E. Vulpe has completed a training program in Nuclear Cardiology that meets the requirements as outlined in ACC/ASNC COCATS Guidelines [revised 20001.

Dr. Marian E. Vulpe is competent to independently function as an authorized user under ~

NRC 10 CFR 35.290 uses.

and Cardiac Stress Testing

Authorized User New York City Bureau of Radiologic Health Radioactive Materials License #75-2898-0 1

Page 3: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

SUBMITTED BY: A. Berendt Assoc. Inc. 888-273-4628

CURRICULUM VITAE

OFFICE ADDRESS St. Luke's-Roosevelt Hos ita1 Ctr. Division of Cardiology-3' Fl 11 11 Amsterdam Ave New York, NY 10025 212 523-4008; pager 3-3658

f:

BIOGRAPHICAL DATA

HOM% ADDRESS

EDUCATION

Sept. 1984-Oct. 1990-M.D., University of Timisoara School of Medicine, Timisoma, Romania; GPA 3.9Y4.00 Sept. 197 1 -June 1983-HS DiplomdBaccalaureate; Major-Mathematics, Science; Nikolaus Lenau Lyceum,

Timisoara, Romania

POSTDOCTORALlPOSTGRADUATE TRAINING

July 2004-June 2005-Cardiology Fellowship, St. Luke's-Roosevelt Hospital Ctr.-Columbia University of P & S,

July 2002-June 2004-Cardiology Fellowship, Graduate Hospital, Philadelphia, PA-Hahnemann University July 2000-June 2002-Nuclear Cardiology Fellowship, Massachusetts General Hospital-Harvard University

July 1997-July 2000-Residency training in Internal Medicine, Kingsbrook Jewish Med. Ctr.-a teachmg affiliate

New York, NY

Boston, MA

of S U N Y HSC at Brooklyn, NY -Chief Medical Resident

Sighisoara Municipal Hospital, Siglxsoara, Romania Dec 1990-0ct 199 1 -Internal Medicine internship/Cardiology track, University of Tirgu-Mwes SOM-affiliated

ADDITIONAL EDUCATION

Oct 2004-4'h Annual Echo New York, NY, NY PERSOKAL INFORMATION WAS REMOVED BY NRC. NO COPY OF THIS INFORlYlATlON

WAS RETAINED BY THE NRC, _ _

Page 4: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

SUBMITTED BY: A. Berendt Assoc. Inc. 888-273-4628

Sept-Oct 2004-9’ Annual ASNC Scientific Sessions, NY, NY May 2004-ACC Nuclear Cardiology Symposium-Seattle, WA Sept. 2003-State-of-the-Art Arrhythmia Symposium-University of Pennsylvania, Philadelphia, PA July 2003-Nuclear Cardiology Symposium, University of Maryland, Baltimore, MD May 2003-Core Curriculum Echocardiography-ACC, Orlando, FL May 2003-Acute Cardiac Care Symposium-WHC, Washington, D.C. Jan 2003-Arrhythmias and Heart Failure-St. Luke’s Roosevelt Hosp/Columbia Univ, New York, NY Nov 2002-73rd Scientific Sessions-AHA, Chicago, IL Feb 2002-State-of-the-Art Echocardiography-ACCNayo, Tucson, AZ Nov 2001 -72nd Scientific Sessions-AHA, Anaheim, CA May 2001 -22nd Annual Scientific Sessions-NASPE, Boston, MA Jan 2001 -6’ International Symposium on Atrial Fibrillation, Boston, MA Fall 2000-Spring 2002-Cardiology Grand RoundslMGH-weekly Oct 2000-Prevention of a second Heart Attack-MIT Endicott House/Harvard Medical School Dec 1999-Cardiac Anhythrmas Diagnosis and Treatment-Drs. Prystowsky, Cannom, Waldo Dec 1999-Seminar Series on Nuclear Cardiology-ACC 1-4 Nov 1 999-70th Scientific Sessions-AHA, Atlanta, GA Sept 1999-Annual Conference of the New York Cardiological SocietyNSC of ACC Aug 1999-Intensive Review of Internal Medicine-Harvard Medical School and Brigham and Women’s Hosp,

April, July 1999-Heart Failure therapy:the role of beta-blockade-Milton Packer, New York, NY March 1999-Vascular Imaging and htervention-State-of-the-Art-Maimonides Med. Ctr., Brooklyn, NY

-

b

Bdton, MA

CERTIFICATION AND LICENSURE

ECFMG -Dec 1994 USMLE-Step 1 -Sept 1993-209/84- 1 st attempt

Step 2-Sept 1994-2O8/83-ls‘ attempt Step 3-May 1999-1 86/8O-ls‘ attempt

NY State license since 2000; MA limited license 2000-2002; PA training license since 2002 ABM Board certified Aug 2000-Internal Medicine BE Cardiovascular Diseases/ABIM-2005 Echo and Nuclear Board certification exams planned-2005

HOSPITAL AND ACADEMIC APPOINTMENTS

Research Fellow in Medicine-Harvard University/HMS, July 2000-June 2002 Chief Resident-Internal Medicine Residency Program-KJMC, Brooklyn, NY 1999-2 I

HONORS AND AWARDS

1994 Certificate of Appreciation, North Broward Medical Center, Pompano Beach, FL 1987 National conference award for study on “Positive inotropic properties of Helleborus derivatives”,

Page 5: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

--

SUBMITTED BY: A. Berendt Assoc. Inc. 888-273-4628

Unh of Tirgu-Mures SOM, Tirgu-Mures, Romania 1986 and 1985 Professional contest national awards in Anatomy and Physiology, Timisoara, Romania 1983 National Physics Olympics award; Iasi, Romania 1980-1 982 State Mathematics Olympics awards, Timisoara, Romania

ASSOCIATION MEMBERSHIP

American College of Cardiology-Fellow-in-Training; (ACP-ASIM, AMA, Massachusetts Medical Society)

THESES

1990-Exploration of malignant Ventricular Arrhythmia and prediction of Sudden Cardiac Death by precordial ECG mapping-unpublished doctoral dissertation, University of Timisoara SOM

CONFERENCE PRESENTATIONS/RESEARCH

2001-2002-Phase I BMlPP study in normal subjects using planar imaging and SPECT-MGH; Co-PI; 2000-2002/ongoing-Forme h s t e of Brugada Syndrome in patients with Ventricular Fibrillation-MGH 2000-2002/ongoing-Management of Sleep Apnea and its impact on cardiovascular disease-SRWMGH 200 1 -Update on the management of Atrial Fibrillation-SRH/MGH 2000,2002-Update on the management of Ventricular Arrhythmias-KJMC and SRWMGH 1999-Multiple pyogenic liver abscesses due to Klebsiella pneumoniae and association with Diabetes mellitus-

1998-SIADH-case presentation and review-KJMC, Brooklyn, NY 1989- 1990-H.pylori (C. py1ori):Pathogenetic role and therapeutic implications in chronic gastritis and peptic

1987-Positive inotropic properties of Helleborus derivatives-National conference presentation and Academy of

1987-Cardiovascular, respiratory and metabolic effects of cycloergometric exercise-National conference

1986-Genetic aspects of Retinoblastoma etiology-symposium, Timisoara, Romania 1985-Molecular and submolecular mechanisms of gene expression and regulation linked to the thermodynamics

poster at ACP-ASIM New York Downstate meeting; publ. J Miss State Med Assoc 2001 Mar;42(3):67-70

ulcer disease-research at Univ of Timisoara SOM, County Hospital

Medical Sciences contract, Tirgu-Mwes, Romania

presentation, Tirgu-Mures, Romania

of irreversible processes-symposium, Timisoara, Romania

MAJOR RESEARCH AND TRAINING INTERESTS

Comprehensive specialty training in noninvasive and invasivehterventional Cardiology, including research and teaching, focusing on clinical integration of structural and functional imaging modalities in ischemic heart disease.

Expanding knowledge pool of biostatistics and clinical decision analysis into advanced research and practice tools.

Pathophysiology and clinical impact of cardiac remodeling; vascular biology and hemodynamic modeling.

Page 6: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

SUBMITTED BY: A. Berendt Assoc. Inc. 888-273-4628

Chaos and complexity theories, nonequilibrium thermodynamics of antientropic systems, energetic concepts of information transmission and their application to cardiovascular function and regulation.

Integrative basic science, such as genetics and immunology, and their impact on cardiovascular medicine.

Individual and community-oriented health education and disease prevention.

PROFESSIONAL EXPERIENCE

July 2004-June 2005-Cardiology Fellowship-St. Luke's Roosevelt Hosp. Ctr.-Columbia University of P&S July 2002-June 2004-Cardiology Fellowship-Graduate Hospital, Philadelphia, PA July 2000-June 30,2002-C1inica1 and research noninvasive Cardiology Fellowship-Massachusetts General Hospital/Harvard University July 1997-June 2000-Internal Medicine Residency-Kingsbrook Jewish Med Ctr, Brooklyn, NY;

Oct 1992-June 1997-ECG Monitor Technician-North Broward Med CtrPompano Beach, FL; Holy Cross Hosp.

Oct 1991 -0ct 1992-Anival in the US, political asylum proceedings, work authorization, test prep-USMLE, all

Dec 1990-0ct 1991-Internal Medicine internship/Cardiology track-Sihsoara Municipal Hospital, an affiliate

Oct 15-Nov 30,1990-postgraduation administrative prep for internship starting Dec 1,1990

-Chief Medical Resident

Ft. Lauderdale, FL

inMiami, FL

of the Univ of Tirgu-Mures SOM

TEACHING EXPERIENCE

July 2002-present-teaching medical students, interns, residents, CME Grand Rounds-Graduate Hospital; SLRH July 2000-June 2002-medical student teaching and Cardiology Grand Rounds presentations-MGWSRH July 1998-June 2000-junior resident teaching, including Chief Resident duties-KJMC 1992- 1997-inservices on arrhythrma classification, identification and management; ECG diagnosis; pacemaker-

1991 -Internal Medicine-Red Cross student course-SMH related normal and abnormal function-NBMC

COMMITTEE MEMBERSHIP

1998-2000-Committee on procedures and ICU/CCU-KJMC 1989- 1990-Chairman, Scientific Commission-Timisoara Medical Student Union (founder) 1989-1990-Senate member-Univ of Timisoara SOM 1989- 1990-Student leader

PERSONAL

Leisure-tennis; travel-

Page 7: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

SUBMlTTED BY: A. Berendt Assoc. Inc. 888-273-4628

REFERENCES-available upon request

Alan Rozanski, M.D. Program Director Cardiology Fellowship St. Luke’s Roosevelt Hosp. Ctr 1 11 1 Amsterdam Ave New York, NY 10025 Tel212 523-401 1

George Chamoun, M.D. (Former Program Director, Graduate Hospital) Lankenau Hosp.-MainLine Health System Div. of Cardiology 100 Lancaster Ave, MOBE Ste 356 Wynnewood, PA 19096 Tel610 649-7625

Gerasimos Zervos, M.D. Associate Director, Nuclear Cardiology Massachusetts General Hospital Cardiac Unit Associates 275 Cambridge St, POB 301 Boston, MA 021 14 Tel617 726-9292

Page 8: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

VULPE, MARIAN E HD HEARTCARE ASSOCIATES OF CT, LLC 2200 WHITNEY AVENUE, STE 180

HAHDEN CT

11l11111l11111l111111111111111111111111111111111111l

6 0 I W

06518-0000

HAMDEN CT 0651 8- 0000

DEA REGISTRATION THIS REGISTRATION FEE NUMBER EXPIRES PAID

2200 WHITNEY AVENUE, STE 18

I

1 ADDRESS CHANGE REQUEST BV9277648

: VULPE, MARIAN E MD

I , NewAddress

I

I

I

I

i cltv State Zip Code

See back fs: 33d%i0~3! rnforraticr. Date , Signature

i I

CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE UNITED STATES DEPARTMENT OF JUSTICE

DRUG ENFORCEMENT ADMINISTRATION WASHINGTON, D C 20537

DEA REGISTRATION THIS REGISTRATION FEE NUMBER EXPIRES PAID

BV9277648 05-3 1-2008 FEE PAID

SCHEDULES BUSINESS ACTIVITY ISSUE DATE

229% P RACTl TI ON E R O S 10-2005 3,3N,4,5

VULPE, MARIAN E MD HEARTCARE ASSOCIATES OF CT, LLC 2200 WHITNEY AVENUE, STE 180

824 and 958) of the as amended, provide

evoke or suspend a anufactore, distribute,dispense, import or

Page 9: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

S T A T E O F C O N N E C T I C U T DEPARTMENT OF CONSUMER P R O T E C T I O N

1 6 5 C a p i t o l A v e n u e + H a r t f o r d C o n n e c t i c u t 0 6 1 0 6

Attached is your registration Such registration shall be shown to any properly interested person on request. Visit our web site at www.state.ct.us/dcp/

MARIAN E VULPE MD

P PERSONAL INFORMATION WAS R EM QVED BY NRC. KO COPY OF THIS INFGFii,;ATION

WAS RETAINED BY THE NRC. I

Yes

Effective: 06/01/2005

Page 10: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

z

8 8 P m .. 0 Y

6

Department of Public Health

Marian Emanoil Vuipe M.D. having given evidence satisfacbry to the Department of Public Health

of havlng met the qualfficatbns requlred by the General Statutes hi 0 a

. . E P U

I

81 a

J. Robert Gal vin. M.D., M.P.H, COMMISSIONER

Page 11: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

___ _.

uepanment of Consumer Protection License Details Page 1 of 1

7

CSP.0037532 - CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER No ReQuirements Found

License Details Name: MARIAN E VULPE MD Business Name:

CONTROLLED SUBSTANCE REGISTRATION FOR cmdenttaf PRACTITIONER

status: ACTIVE

CSP.OO(l7532) Effective Date: 0610 1 /ZOO5 Credential Number:

Sub Category: Expiration Date: 02/28/2006

To view Complaint or Disciplinary History click button ...

PERSOKAL INFORMATION WAS REMOVED BY NRC. NO COPY OF THIS INFORIdATION

WAS RETAINED BY THE NRC, ---/

http://www. dcpaccess. state. ct. us/DCPPublic/pDetail. asp?id=405 829 6/4/2 005

Page 12: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

A FULL SERVICE MEDICAL PHYSICS GROUP

Roberta J. Thomas, CNMT Heartcare Associates of Connecticut 2200 Whitney Avenue #180 Hamden, CT 06518

February 2 1,2005

Dear Ms. Thomas: Diagnostic Radiolog!.

hlanimograph y

Computed Tomography

M R I Accreditation

Iltrasound

Kuclear hledicine

PET/SPECT

Radiation Therapy

Kadiation Safety

Industrial Radiography

Yeterinary Nuclear hledicine

Education/Training

Cleveland Office 1007 Roland Road

Lyndhurst. Ohio it4124 Corporate Office

Offices In: Cincinnati. OH

Yew Orleans. LA Covington. LA

Pittsburgh, P..\

Orlando. FL Ar 1 in gto ti. TX

Please allow this letter to be used for reference regarding my recommendation for you to serve as a Radiation Safety Oficer. For the past 34 months, you have maintained all required record keeping necessary for the Nuclear Regulatory Commission, reviewed film badge records, identified problems within the department relative to radiation safety and have been able to maintain a safe working environment.

In addition to the above, you have demonstrated the appropriate knowledge of quality control regarding instrumentation as required by the Nuclear Regulatory Commission. You have assisted in radiation safety training for the ancillary staff and have been able to address any of their questions regarding radiation safety matters.

You have demonstrated adequate knowledge of the rules and regulations for working with radioactive materials and consistent with the duties of a Radiation Safety Oficer.

Should you require any other information regarding this, please feel free to contact me directly at 888-934-1 871.

Charles Anthony Giom (

Medical Physicist F- Radiation Safety Officer to Heartcare Associates of Connecticut

Fax: it40 473 0056

w w w . a m p r . ne t

Page 13: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

~-

Academic History Page 1 of 4

Gateway Community College

Display Academic History Q00588889 Roberta J. Thomas I, .- c m onnc ni . 4 o ..-

" ' * ' - r" ' "-.. -", -"""

This is NOT an official transcript. Courses which are in progress may also be included on this transcript.

Institution Credit Transcript Totals

Transcript Data

STUDENT INFORMATION

Name : Birth Date:

DEGREE INFORMATION

Awarded: Associate in Science Degree Aug 01, 1997

Inst i tut ional Honors honors: Major: Nuclear Medicine

Date:

Technology

PRE-SYSTEM INSTITUTION SUMMARY HOURS -Top-

Attempt Passed Earned GPA Quality GPA Hours Hours Hours Hours Points

Total:

Unofficial Transcript

INSTITUTION CREDIT -Top-

Fall 1987 CRN Subject Course Level Title Grade Credit Quality R

3168 ENG I121 I1 COMPOSITION I B 3.000 9.00 3194 RDG 1100 I1 DEVELOPMT READING A 3.000 12.00

Hours Points

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 6.000 6.000 6.000 6.000 21.00 3.50 Cumulative: 6.000 6.000 6.000 6.000 21.00 3.50

Unofficial Transcript

Spring 1988 CRN Subject Course Level Title

7660 DAPR I101 I1 INTROTODAPR

Grade Credit Quality R

C 3.000 6.00 Hours Points

https://www .online.commnet.edu/pls/i/bwskotrn.P-ViewTran 6/30/2005

Page 14: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

Academic History

Current Term: Cumulative:

-

Page 2 of 4

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

3.000 3.000 3.000 3.000 6.00 2.00 9.000 9.000 9.000 9.000 27.00 3.00

Unofficial Transcript

Fall 1988 CRN Subject Course Level Title Grade Credit Quality R

3524 PSYC I105 I1 CHILD GROWTH &DEV B 3.000 9.00 Hours Points

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 3.000 3.000 3.000 3.000 9.00 3.00 Cumulative: 12.000 12.000 12.000 12.000 36.00 3.00

Unofficial Transcript

Fall 1993 CRN Subject Course Level Title Grade Credit Quality R

7856 MATH I101 I1 FUNDOFMATH B+ 3.000 9.90 Hours Points

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 3.000 3.000 3.000 3.000 9.90 3.30 Cumulative: 15.000 15.000 15.000 15.000 45.90 3.06

Unofficial Transcript

Spring 1994 CRN Subject Course Level Title Grade Credit Quality R

4318 ENG I122 I1 INTRO LIT/COMP I1 C+ 3.000 6.90 4452 MATH I105 I1 STRUCTNUM SYS I A 3.000 12.00

Hours Points

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 6.000 6.000 6.000 6.000 18.90 3.15 Cumulative : 21.000 21.000 21.000 21.000 64.80 3.08

Unofficial Transcript

Fall 1994 CRN Subject Course Level Title Grade Credit Quality R

Hours Points 5040 BIO I115 I1 HUMAN BIOLOGY B 3.000 5132 CHE I l l O I1 INTRODUCTORY CHEM B- 3.000 8012 RAD I l l O I1 INTRO TO RADIOLOGY P 3.000

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 9.000 9.000 9.000 6.000 17.10 Cumulative: 30.000 30.000 30.000 27.000 81.90

Unofficial Transcript

9.00 8.10 0.00

2.85 3.03

https://www .online.commnet.edu/pls/i/bwskotm.P-ViewTran 6/30/2005

Page 15: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

Academic History

Spring 1995 CRN Subject Course Level Title Grade Credit Quality R

4062 BIO I127 I1 ANATOMY & PHYS I A 4.000 16.00 4156 COM I101 I1 FUND SPEECH COMMUN B+ 3.000 9.90 7260 PHY I115 I1 PHYSICS FOR TODAY B- 3.000 8.10

Hours Points

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 10.000 10.000 10.000 10.000 34.00 3.40 Cumulative: 40.000 40.000 40.000 37.000 115.90 3.13

Unofficial Transcript

Fall 1995 CRN Subject Course Level Title Grade Credit Quality R

3914 MAT I112 I1 MATFORSCItATECH A- 3.000 11.10 3370 NMT I l l 1 I1 INTRO NUCLEAR MED B- 3.000 8.10 3372 NMT I112 I1 CLINICAL PRACTIC I P 1.000 0.00 5688 PSY I101 I1 INTRO TO PSY A 3.000 12.00

Hours Points

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 10.000 10.000 10.000 9.000 31.20 3.46 Cumulative : 50.000 50.000 50.000 46.000 147.10 3.19

Unofficial Transcript

Spring 1996 CRN Subject Course Level Title Grade Credit Quality R

2902 BIO I128 I1 ANATOMY & PHYS I1 A 4.000 16.00 2908 NMT I125 I1 CLINICAL PRACTI I1 P 1.000 0.00 2910 NMT I211 I1 PHYS/NUC MED TECH A- 3.000 11.10 2922 PHY I116 I1 PHYSICS/LIFE SCIEN B 4.000 12.00

Hours Points

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 12.000 12.000 12.000 11.000 39.10 3.55 Cumulative: 62.000 62.000 62.000 57.000 186.20 3.26

Unofficial Transcript

Fall 1996 CRN Subject Course Level Title Grade Credit Quality R

3906 NMT I213 I1 NUCMED IMG PROCI B 3.000 9.00 3908 NMT I215 I1 CLINICAL PRACT I11 P 1.000 0.00 3910 NMT I224 I1 DETECT/MEAS NU RAD A- 3.000 11.10 3912 NMT I226 I1 RADIOPHARMACY A- 3.000 11.10 3940 RST I211 I1 PATHLOGY I B+ 3.000 9.90

Hours Points

Attempt Passed Earned GPA Hours Hours Hours Hours Points

Quality GPA

Current Term: 13.000 13.000 13.000 12.000 41.10 3.42

https://www .online.commnet.edu/pls/i/bwskotrn.P-ViewTran 6/3 0/2oO5

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Academic History Page 4 of 4

Cumulative: 75.000 75.000 75.000 69.000 227.30 3.29

Unofficial Transcript

Spring 1997

CRN Subject Course Level Title Grade

2910 N MT 2916 NMT 2918 NMT 2920 NMT 2922 N MT 2970 RST

Current Term: Cumulative:

I124 I1 COMPUTERS NUCL MED B I214 I1 QUAL CONTROYMGMT B+ I221 I1 CLINICAL PRACTI IV P I228 I 1 NU ME IMAG PROC I 1 B I230 I1 NUC MED TECH S/SEM A I226 I1 PATHOLOGY I1 A-

Attempt Passed Earned GPA Quality GPA Hours Hours Hours Hours Points 14.000 14.000 14.000 13.000 43.00 89.000 89.000 89.000 82.000 270.30

Unofficial Transcript

TRANSCRIPT TOTALS (GWCC CREDIT) -TOP-

Total Institution: Total Transfer: Overall:

Unofficial Transcript

RELEASE: 6.1

Credit Quality R Hours Points 3.000 9.00 3.000 9.90 1.000 0.00 3.000 9.00 1.000 4.00 3.000 11.10

3.30 3.29

Attempt Passed Earned GPA Quality GPA Hours Hours Hours Hours Points 89.000 89.000 89.000 82.000 270.30 3.29

0.000 0.000 0.000 0.000 0.00 0.00 89.000 89.000 89.000 82.000 270.30 3.29

https://www .online.commnet.edu/pls/i/bwskotm.P-ViewTran 6/30/2005

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Page 18: HeartCare Associates of Connecticut, LLC, Amendment ... · of the Univ of Tirgu-Mures SOM TEACHING EXPERIENCE July 2002-present-teaching medical students, interns, residents, CME

This is to acknowledge the receipt of your letter/application dated

, and to inform you that the initial processing which includes an administrative review has been performed.

m d .I 06 -?e 702 -df

$There were no administrative omissions. Your application was assigned to a technical reviewer. Please note that the technical review may identify additional omissions or require additional information.

0 Please provide to this office within 30 days of your receipt of this card

A copy of your action has been forwarded to our License Fee 8 Accounts Receivable Branch, who will contact you separately if there is a fee issue involved.

Your action has been assigned Mail Control Number d 3 7 7 6 p ,

When calling to inquire about this action, please refer to this control number. You may call us on (610) 337-5398, or 337-5260.

NRC FORM 532 (RI)

(6-96)

Sincerely, Licensing Assistance Team Leader