CALL TO ORDER AGENDA MINUTES - Georgia Composite …

Georgia Composite Medical Board

Minutes of the May 6, 2021 Meeting

1

The Georgia Composite Medical Board (GCMB) held its regular meeting on May 6, 2021 via

teleconference at 2 Peachtree Street, Atlanta, GA 30303, to consider Medical Board matters.

Board members on the call:

John S. Antalis, MD

William Bostock, DO

Gretchen Collins, MD

Debi Dalton, MD

E. Dan DeLoach, MD

Charmaine Faucher, PA (ex-officio)

Austin Flint, MD

Judy Gardner, FASHP, Consumer Member

Alexander Gross, MD

Shawn Hanley, Consumer Member

Thomas Harbin, MD, Vice Chair

J. Jeffery Marshall, MD

Andrew Reisman, MD

David Retterbush, MD

Barby Simmons, DO, Chair

Board member absent: Matthew Norman, MD

Management staff present: LaSharn Hughes, MBA, Executive Director

Phyllis White, Executive Assistant

Jonathan McGehee, Director of Investigations

Latisha Bias, Enforcement Supervisor

Legal staff on the call: Max Changus, JD, Assistant Attorney General

Betsy Cohen, JD, Assistant Attorney General

CALL TO ORDER Dr. Simmons called the meeting of the Georgia Composite Medical Board to order at 7:30 a.m.

AGENDA Dr. Marshall made a motion, seconded by Dr. Reisman to approve the agenda of the May 6, 2021

meeting. The motion carried unanimously.

MINUTES Dr. Retterbush made a motion, seconded by Dr. Harbin to approve the minutes of the April 1,

2021 meeting. The motion carried unanimously.

EXECUTIVE DIRECTOR’S REPORT Ms. Hughes, Executive Director, presented the following report:

Mr. McGehee has made progress in updating the Board’s website from the suggestions from the Audit

and Ms. Faucher, Chairman of the Public Outreach Committee.

Ms. Hughes updated the Board on the difficulties in hiring staff, since the pandemic. She is hopeful to

be fully staffed soon.



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Request from Stephanie Saladino, whether the Board has interpreted or has issued any guidance

regarding the definition of an “FDA-approved treatment” under the Georgia Right to Try Act (Ga. Code

31-52-4). Specifically, we want to understand whether the term “FDA-approved treatment” includes

surgical procedures as well as therapeutics. The Board referred Ms. Saladino to Department of

Community Health for a response, since this is not in the Board’s laws or rules.

Request from Christy Hembree searching for information on Radiology Practitioner Assistants (RPAs).

We need information regarding GA law in the hospital setting (IP/OP/ER). The Board referred the

request to the Rules Committee.

Request from the Wisconsin Board of Medicine, which is currently undertaking a review of licensees

(physicians, physician assistants, etc.) who are practicing what is being referred to as “Functional

Medicine” (including but not limited to Platelet Rich Plasma injections, and Bio-Identical Hormone

Replacement therapy). The Board is interested in the position, if any, of other State Medical Boards,

and relevant agencies such as FSMB with regard to this type of practice and whether it is within the

scope of acceptable practice of medicine and surgery and within the standard of care of such practice.

The Board has not had any issues with this practice.

RULES HEARING Motion Dr. Harbin, seconded Dr. Marshall and motion carried to adopt the following rules:

Rule 360-2-.05 Renewal Applications

Rule 360-5-.02 “Qualifications for Physician Assistant License”

Rule 360-5-.03 “Application for Physician Utilization of a Physician Assistant”

Rule 360-5-.04 “General Job Description”

Rule 360-5-.05 “Limitations on Physician Practice”

Rule 360-5-.06 “Renewal of Physician Assistant License”

Rule 360-5-.11 “Standards for Physician Assistant Practice”

Rule 360-5-.12 “Guidelines concerning Prescriptive Authority”

Rule 360-32-.01 “Definitions”

Rule 360-32-.02 “Requirements for Nurse Protocol Agreements Pursuant to Code Section 43-34-25.

REVIEW HEARING Richard Blake, PA, requested a review hearing. Max Changus, Assistant Attorney General, appeared on

behalf of the Board. Mr. Blake was represented by Attorney Matt Bass. The Board members asked

questions, then Mr. Blake and his attorney responded. The Board voted to go into Executive Session to

deliberate. Dr. Simmons declared the meeting in Open Session. Dr. Retterbush made a motion,

seconded by Dr. Harbin, to uphold the Initial Decision of the Administrative Law Judge. Dr. Reisman

and Dr. DeLoach both abstained.

CLOSED SESSION Dr. DeLoach motioned seconded by Dr. Dalton to go into closed session to discuss applications,

investigations and disciplinary matters. The motion carried unanimously.



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OPEN SESSION Dr. Simmons declared open session.

ATTORNEY GENERAL (AG) Max Changus, Assistant Attorney General presented the AG Status Report. Dr. Marshall submitted a

motion, seconded by Dr. DeLoach and motion carried to accept the report as information and approved

the following Board Orders:

ORDERS FOR APPROVAL:

John Seal, Cease and Desist Order

Michael Bowen, RCP

David Toone, Acupuncturist

Natalie Jackson, SLP

Ovez Sitifiawala, PA

Tracy Lynn Deltac, ALP

Andrea Chancey, PA

John Farrior, PA

Angela L. McDowell, DO

Myla Bennett, MD

PHYSICIAN LICENSURE COMMITTEE Dr. Retterbush presented the Licensure Committee Report:

The Board took the following actions:

Approve Petition(s) to Waive Rules

Brazzale, Katherine – Rule 360-2 - .02

Midence, Carlos – Rule 360-2-.01 (f) ii

Approve Petition(s) to Waive Rules Pending

Chintala, Sreedhar – Rule 360-2- .02: USMLE Score Transcript

Deny Petition(s)to Waive Rule(s)

Kelleigh, Courtney – Rule 360-2- .01 (e)(i). Must take an examination.

Questions/Requests

Deny request from Shohab Virk for Board Sponsorship to Retake the USMLE Step 1.

Deny request from Neel Patel for Board to accept training of AACMFS instead of ACGME.

Approve License Applications:

Initial

Cornish, Eboni

Garg, Ruchi

Goldberg, Michael

Hill, Domonic

Karagas, Michael



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Kokocki, Stanley

Lee, David

Maher, James

Maxwell, Robert

McKinney, Terry

Rageh, Abdouirahman

Rehman, Faiz

Robinson, Julie

Shields, Jessica

Smith, Nathan

Sood, Rajiv

Varanasi, Ballavital

Webber, Matthew

Welsch, Michael

Wroblicky, Peter

Residency Training Permit Pending

Fazal, Rahim – ECFMG certification certificate

Reinstatement

Lettsom, Lyndell

Novince, Ryan

Rhodes, Vicki

Administrator in Medicine

Pearce, Melissa (AIM)

Institutional

Da Costa, Adilson

Approve Residency Training Permit Renewals

Schild, Chris

Ibrahim, Ghaith

Adams, Sarah

Kham, Ambreen

Mudaliar, Prathik

Approve License Application Pending

EW

Administrative License, Clinical Skills Examination or Allow to withdraw or Deny

RB

HW

JR

Table

AH – for additional information.



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Deny

KC (Institutional)

ET - Deny based on permanent suspension of NJ medical license.

ADMINISTRATIVELY APPROVED

Name Degree

Abdelkarim, Riad Z MD

Adair, Dionne MD

Addo, Basilio N MD

Addo, Jennifer E MD

Adeniyi, Abdul-Razaq MD

Adu-Gyamfi, Kwabena O MD

Agasarkisian, Lousine MD

Agboola, Nuratullahi O MD

Agdassi, Haleh MD

Ahmad, Mazna T MD

Akbar, Syed A MD

Alderson, Chevon M MD

Alex, Kezia MD

Alic, Linda L MD

Almasi, Patris MD

Alonso, Zin H MD

Antzoulatos, Eleni MD

Appleby, Megan L MD

Appleton, Nicolas C MD

Asangmbeng, Nformbuh MD

Ashimolowo, Toluwalase MD

Asuzu, Christopher C MD

Athreya, Hariharan MD

Avila Hernandez, Adrian N MD

Azam, Mohammad U MD

Aziz, Madiha MD

Bandhakavi, Vijay MD

Barnett, Robert K MD

Bauer, Joseph M DO

Bellam, Clayton P DO

Bender, Gregory MD

Bertino, Frederic J MD

Beus, Jonathan M MD

Bodine, Charles MD

Boghani, Zain MD



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Bohannon, Katherine E DO

Boissonneault, Adam R MD

Bontrager, Travis D MD

Booy, David N MD

Bordlee, John MD

Bowles, Richard J MD

Brady, Evan K MD

Brasfield, Kirasten G MD

Brazzale, Katherine L MD

Brittsan, Caylie P MD

Brock, Paul B, Jr MD

Brown, Jacqueline T MD

Bsirini, Caroline MD

BUCH, KUNAL MD

Buono, Alyssa B MD

Burch, Joseph S MD

Burrer, Phillip F MD

Butler, Shauna M MD

Cail, Austin J MD

Caldwell-Sachar, Haven L DO

Callahan, Daryl J DO

Caro, Christina G MD

Carswell, Lindsey DO

Carter, Ann-Gelle S MD

Cavallo, Gina M MD

Cawley, Clinton M MD

Chan, Christopher DO

Chand, Rohin DO

Chaudhary, Dhruv R MD

Chintala, Sreedhar MD

Chopra, Swati MD

Chow, Kevin L MD

Christenbury, Mary M MD

Christenson, Vernon L MD

Claudio-Gonzalez, Ivan L MD

Clavijo, Alex MD

Close, Brian M MD

Cochi, Shea E MD

Cole, Adam J MD

Conti, Paul A MD

Cook, Schuyler DO

Cooper, Joel R MD

Cornish, Eboni MD



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Cox, Ralph F, Jr MD

Cranford, Michael C DO

Creel, Rebecca G MD

Crismon, Heidi MD

Cullison, Timothy A MD

Cummings-Johnson, Paige M DO

Daniel, Alexander E MD

Daskalakis, Demertre C MD

Davidson, Sean R MD

Dawit, Sara MD

Day, Matthew J DO

De Leon Benedetti, Andres M MD

Deal, Joshua MD

Dean-Colomb, Windy MD

DeBeaux, Austin C MD

DeCesare, Gary MD

Defore, Salome E MD

Delamota, Jessica I DO

Desai, Shivang R MD

DeSouza, Stephen M MD

Dickstein, Ross MD

DiGiandomenico, Stefanie M MD

Dimitrijevic, Oliver MD

Do, Thanh M DO

Doane, TristanT MD

Donatien, Jose MD

Doshi, Ricky MD

Drylewicz, Monica R MD

Durkin, Sean J MD

Earl, Victoria C MD

Egbo, Obinna P MD

Elfar, Mohamed MD

Erlich, Victor M MD

Essa, Amr MD

Evans, Austin J MD

Evans, Casey B MD

Evans, Whitney MD

Farooqui, Amreen MD

Farwell, Charles D MD

Feldpausch, Nora I MD

Ferenczy, Joshua MD

Floyd, Matthew T MD

Fortner, Corwyn MD



8

Franckowiak, Emily MD

Fung, Russell K MD

Fussner, Steven L MD

Gage, Harold A MD

Gagnon, Marie-Helene MD

Galper, Merav MD

Galvan, Erickson R MD

Garden, Benjamin C MD

Garg, Ruchi MD

Geneve, Nikerson DO

Ghate, Deepta A MD

Gillen, Matthew C MD

Gilliam, Lynda MD

Glaser, Charles I MD

Gleason, Bonnie T MD

Gnanajothy, Rosana MD

Goldberg, Michael T MD

Goldstein, Matthew DO

Gonzalez-Beicos, Aldo MD

Gorle, Swathi MD

Graham, Tiffany M MD

Grant, Daniel N MD

Gray, Joseph M MD

Grijalva, Steven D MD

Grimes, Joanna M MD

Guerrero-Calderon, Juan D MD

Habib, Adnan N MD

Hajighasemi-Ossareh, Mohammed MD

Hall, Charles MD

Hall, Jennifer B MD

Hallett, Thao-Phuong C MD

Hampton, Stephanie F MD

Harper, Benjamin T MD

Harper, Christopher W, Jr MD

Harris, Lisa K MD

Harris, Nicholas MD

Hatoum, Hadi MD

Hekman, Katherine E MD

Hemphill-Bryant, Zuri D MD

Hill, Domonic J MD

Hira, Jasmina DO

Hito, Rania MD

Holder, Angela J MD



9

Hutchinson, Tanisha R MD

Ibidapo, Kaylah MD

Ibrahim, Saman MD

Illg, Zachary N DO

Iloh, Florence N MD

Irizarry, Rachel MD

Isaak, Kevin A MD

Isnassuos, Mena MD

Jain, Tarun MD

Jamshidi, Raehannah J MD

Jeffries, Howard E MD

Jeter, Robert, II MD

Joe, Deanna S MD

Jones, Margaret R MD

Jonsson, Amalia A MD

Jotwani, Anil MD

Jung, Andrew D MD

Kadiwar, Amisha A MD

Kafrouni, Abdallah MD

Kain, Conor MD

Kane, Dennis R MD

Kang, Julia Y MD

Kang, Myong J MD

Kanter, Jenna R MD

Kanugula, Ashok Kumar MD

Kapadia, Jeet P MD

Kapoor, Madhavi P MD

Kapp, Meghan MD

Kashlan, Khaled N MD

Kawar, Yaser F MD

Khan, Fahad Ullah MD

Khan, Tuba MD

Kieffer, Theodore MD

Kim, Beomjune B MD

Kim, Eric S MD

Klaas, James P MD

Kocharyan, Hakob MD

Kokocki, Stanley P MD

Kostanjevec, Juilett R DO

Kucera, Walter B MD

Kuhn, Karin MD

Kunkel, Katherine J MD

Kwon, Elena H DO



10

Lamousin, James C MD

Large, Thomas M MD

Lassinger, Brett C MD

Lawson, Eric C MD

Leahman, Courtenay MD

Lee, David MD

Lee, Kameryn MD

Leumas, Jordan K MD

Leung, Enoch C MD

Levine, Jennifer B DO

Lightsey, Joseph M MD

Lillo, Sara N MD

Lin, Eric Z MD

Lin, Jenny MD

Liolios, Antonios MD

Liou, Victor MD

Lirette, Ryan W MD

Little, Yvonne M MD

Locrotondo, Tony DO

Lodebo, Bereket T MD

Logan, Danielle R MD

Logterman, Stephanie L MD

Lopez, George MD

Loungani, Rahul S MD

Loy, Brienne J MD

Luce, Lindsay MD

Lyon, Albert W MD

Madbak, Firas MD

Magruder, Jonathan T MD

Maher, James E, III MD

Malenke, Jordan MD

Malik, Sitwat F MD

Mallick, Faryal MD

Mandell, Joanna L MD

Mandiga, Hemalata MD

Maness, Caroline B MD

Mann, Patrice A, MD

Mansour, William L MD

Masiewicz, Spencer A DO

Mathai, Abraham MD

Mathew, Taniya S MD

Mattox, Dexter MD

Maurente, Diego N MD



11

Maxwell, Robert A MD

Mayol del Valle, Miguel A MD

McArthur, Erica MD

McBride, Donald W MD

McGrail, Kaitlin MD

McKinney, Terry K MD

McLaren, Matthew D MD

McLaughlin, Ryan C MD

McLean, Keith A MD

McLeod, Cara DO

Medarametla, Srikanth MD

Medina Vega, Rita E MD

Mehta, Akshat J MD

Mehta, Puja MD

Mennie, Peter A MD

Merrell, Desiree MD

Merritt, Clint M MD

Mian, Amir R MD

Michel, Kendra E MD

Milad, Abdulhamid MD

Miller, Janae E MD

Miller, Janelle DO

Miller, Jessica MD

Mishra, Mitushi MD

Mitton, Arielle R MD

Mize, George W MD

Moffatt, Victoria L MD

Mojicar, Luis A MD

Mole, Angelique A MD

Monu, Nicholas MD

Moore Padilla, Michelle M MD

Moore, David C MD

Morisset, Jean-Philippe E MD

Moss, Renee F MD

Motamed, Amy L DO

Muehrcke, Cecile S MD

Mullens, Frank MD

Murphy, Colin G MD

Mushref, Malek MD

Nagy, Celeste Z MD

Najjar, Nadine MD

Narayan, Dwayne A MD

Nazinitsky, Allison L MD



12

Nelson, Corrine R MD

Nelson, Daniel G MD

Netherton, Cynthia L MD

Nguyen, Christina MD

Nimmagadda, Neelima MD

Noto, Michael J MD

Novack, Craig DO

Nwanne, Ogochukwu Y MD

Nyange, Christabel E MD

Obetta, Kenechi MD

O'Brien, Colin W MD

Ogbuchi, Samuel I, Jr. MD

Okanu, Ngozi E MD

Omoike, Osereimen MD

Ondersma, Ross M MD

Orange, David MD

O'Shea, Casey MD

Osteen, Erin S MD

Otekeiwebia, Anthony S MD

Ou, Jocelyn MD

Oyefule, Omobolanle MD

Oza, Bhishma DO

Padro Diaz, Willma L MD

Paletta, Nina J MD

Pandit, Trailokya N MD

Parikh, Amy DO

Park, Michelle MD

Parks Ballard, Bari A MD

Pasculli, Rosa M MD

Patel, Dil D MD

Patel, Gopi A DO

Patel, Harsh N MD

Patel, Harshang J MD

Patel, Janak R MD

Patel, Jay D DO

Patel, Jigar J MD

Patel, Kevin K MD

Patel, Kunal MD

Patel, Nilbhi MD

Patel, Parag D DO

Patel, Radhika DO

Patel, Rooshi A MD

Patel, Vatsal G MD



13

Patel, Viral M DO

Payabyab, Eden C MD

Payne, Zachary J DO

Pearce, Melissa W MD

Pearlman, Justin D MD

Pershad, Valerie MD

Peters, John M MD

Petrillo, Sara MD

Pham, Cung B MD

Pham, Jamila-Duyen MD

Philpott, Natalia G MD

Picon, Michelle M MD

Pina, Paloma G MD

Pittman, Patricia D MD

Pole, Ginger L DO

Pollack, Jason M MD

Powell, Benjamin C MD

Powell, Melissa A MD

Powell, Stephen L MD

Prow, Harold W MD

Pullamaraju, Swati MD

Puttu, Sumathi MD

Rabbani, Shimool A MD

Rageh, Abdulrahman MD

Rahman, Sabreen R MD

Ramalingam, Vijaya Sivalingam MD

Ramos, Anika M MD

Rana, Niteshkumar MD

Randazzo-Burton, Theresa MD

Ranganath, Shashi MD

Ranpura, Vishal N MD

Rao, Sudhir R MD

Rashid, Ahmad M MD

Rathee, Vaishali MD

Reese, Erika S MD

Rehman, Faiz U MD

Rekito, Anthony W MD

Richman, Louis MD

Ridge, Margaret MD

Ridley, Wesley A MD

Ritchie, James M DO

Rizvi, Kashan H MD

Roberts, James K MD



14

Robinson, Julie C MD

Rodriguez, Rey L MD

Romancik, Jason T MD

Roque Gardner, Annelys MD

Rosenblum, Richard S MD

Ross, Justin C DO

Royes, Kareem N MD

Rudolph, Adam M MD

Ruiz Vega, Joshuam A MD

Sadeghi, Nick A MD

Sahu, Joya MD

Salabei, Joshua MD

Salas, Stephanie A MD

Salastekar, Ninad V MD

Salcin, Sameena H MD

Samaddar, Ted S MD

Samra, Hasan MD

Sanchez Rivera, Jarvis J MD

Sanders, Aaron MD

Sanders, Jason C, II MD

Sandler-Wilson, Carla L MD

Santy, Eleanor E DO

Sarang, Trushar MD

Sardar, Muhamamd R MD

Sarlay, Robert, Jr. MD

Sarrafi, Madhis MD

Scelsi, Christopher L DO

Schaheen, Basil W MD

Schaheen, Emily C MD

Scheuer, Kim MD

Schley, Stacey MD

Schunn, Christian D MD

Schwartz, Joel DO

Seibolt, Lucas MD

Selhorst, Christopher MD

Sepulveda, Ernesto A MD

Sergeyenko, Yevgeniya MS

Shafran, David M MD

Shah, Freny MD

Shah, Niral MD

Shandley, Lisa M MD

Sharma, Saurabh MD

Sharp, John R, II DO



15

Sheets, Ryan O MD

Sheffield, Sandra L DO

Shelton, Emily A MD

Shelton, Julie E DO

Sheth, Eshani DO

Shiekhmohammed, Mohammed MD

Shields, Jessica A MD

Shull, Hannah E MD

Shulman, Lee P MD

Sidile, Jabulani MD

Silverman, Bruce A MD

Simba, Brian MD

Simpson, Megan K DO

Singh, Shashank S MD

Singh, Simren J MD

Sledge, Caitlin M MD

Smalley, Arion A MD

Smith, Collin M DO

Smith, David N MD

Smith, Leslie DO

Smith, Nathan E MD

Smith, Rachael C MD

Smith, Stacey L MD

Sohn, Yoojin MD

Soifer, Gregg A MD

Songer, Emily A MD

Sood, Rajiv MD

Spelts, Anna F MD

Squier, Samuel B MD

Stangeby, Megan A DO

Starr, Amy DO

Statler, James R MD

Steely, June M MD

Sternad, Lindsay A MD

Stevenson, Jason M MD

Strange, Liberty F MD

Strother, Angela W MD

Stroud, Jennifer N MD

Stubbs, James W MD

Suah, Ashley MD

Summers, Kevin M DO

Summey, Robert D MD

Surapur, Kawanjit K MD



16

Surti, Amy J DO

Sutaria, Tarangi D MD

Sutton, Gregory MD

Swanson, Benjamin F MD

Swavely, Natalie MD

Tang, Anita MD

Tanksley, Parris MD

Tarplin, Sarah J MD

Tarr, Andrew M MD

Terwilliger, Toby D MD

Tesfay, Meron A MD

Testini, Paola MD

Thakkar, Yesha M DO

Thayer, Wesley P MD

Thomas, Julien R MD

Thomas, Justin L MD

Thomas, Orlando W DO

Tillman, Marah C MD

Toister, Shira S MD

Tolu-Ajayi, Christine I MD

Torres, Eliud MD

Tossing, Christopher M MD

Toussaint, Marissa A MD

Tramontana, Jane MD

Traore, Elizabeth J MD

Trissell, Brian MD

Truitt, Brittany A MD

Trzebinska, Danuta MD

Tseng, Hayley K MD

Tupchong, Keegan MD

Twum-Ampofo, Jeffrey MD

Udoetuk, Sade MD

Ugwu, Chidiebere V MD

Umar, Shaheen I MD

Valenzuela, Ashley D MD

Van Rijn, Kilian MD

Varanasi, Balavittal MD

Vardhana, Harsha MD

Verma, Nandini MD

Vines, Tyler B MD

Viqar, Sehrish MD

Vitantonio, Daniel S MD

Vokes, Jordan MD



17

Vuncannon, Danielle M MD

Wagner, Andrew F MD

Wagner, Krystn R MD

Wagner, Lori F DO

Waheed, Salman MD

Wahlmeier, Steven T MD

Walding, Jeffery L MD

Wang, Jeffrey MD

Webb, Chelsy MD

Weinstein, Joseph S MD

Welsch, Michael MD

White, Jessica J DO

Whittemore, Brianna S MD

Wilhoite, David A MD

Williams, Jessica D MD

Wilson, Elizabeth A MD

Wilson, Katherine M MD

Winbush, Nicole Y MD

Witter, Daniel MD

Wolff, Erin MD

Wong, Waikeong P MD

Wright, Brian D MD

Wright, Yonte B MD

Wroblicky, Peter T MD

Xu, Ashley MD

Yesus, Yohannes W MD

Yoshii, Hikari MD

Young, Lisa A DO

Yousefi, Shadi MD

Yu, Jason L MD

Yu, Jonathan DO

Zafar, Blal A MD

Zamfir, Radu A DO

Zayas-Borges, Paola Y MD

Zemlyak, Alla Y MD

Ziegler, Dean W MD

Zolak, Jason MD

Zorrilla, Andres MD

Zuniga, Joshua V MD

NURSE PROTOCOL ADVISORY COMMITTEE Dr. Norman presented the Nurse Protocol Report:



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The Committee recommended the following:

1. An APRN is interested in establishing a medical spa in the state. She inquired with questions and

requirements, MDO and delegating authority. The Board referred her to the FAQ’s and the laws

and rules. Please find below the questions the Board's review and consideration.

The following Form C’s were approved:

❖ Diaz, Betsy

❖ Evans, Angela

❖ Fass, Alexandra

❖ Hartline, Amy

❖ Kairu, Linet

❖ McDaniel, Erica

❖ Oestrelch, Krystal

❖ Rizkalla, Chelsa

❖ Smith, Caitlyn

❖ Wilson, Suzzane

The following Form C’s were not approved:

❖ Evans, Angela (thermiRF, Cellfina, Skin-Only Blepharoplasty, Local Lipo, Thread Lifts and

Minor office procedures)

❖ Louis, Charlot

The Committee reviewed and approved the following protocols under the provision of O.C.C.A.

43-34-25.

APRN Delegating Physician

Berry, Crystal Allen Lavender, Jr., DO

Clark, Cynthia Muhammad Jamil, MD

Clayton, Anna Erik Bauer, MD

Freeman, Julie Timothy Taylor, MD

Morgan, Dana David Faulk, MD

Thrift, Alicia David Faulk, MD

The Committee determined that the following protocol agreements meet the provisions of

O.C.G.A. 43-34-25 with changes.


Buffington, Howard Dhru Girard, MD

Davis, Jamil A. Patrice Daisley Shongo

Felder, Joylove Muhammad Jamil, MD

Harrison, Shirley Charles Jackson, Jr., MD

Hinton, Cindy Allison Dupont, MD

Nelson, Stephanie Livingstone Rasalam, MD



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Rafford, Autumn Leticia Lindsey, MD

Wheeler, Amy Kipp Slicker, DO

Wildes, Deanna Anthony Avino, MD

Williams, Nicole Ganiat Ajayi, MD

Woolwine, Megan Farhan Qureshi, MD

The Committee determined that the following protocol agreements do NOT meet the provisions of

O.C.G.A. 43-34-25.


Barra, Jessica Lanre Udu, MD

Clark, Melissa Kayln Lane, MD

Doirin, Sabine Franckel Val, MD

Miller, Tanya Ram Bishnoi, MD

Natson, Kimberly Sandra Bohsterngel, MD

Sumner, Erin Muhammad Jamil, MD

Wright, Anna Bryon Evans, MD

Yinusa, Bisi Otis Powell, MD

Yngayo, Kathleen Kenneth Dinella, MD

Protocols Administratively Reviewed:

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

APRN Last APRN First Supervising Physician Name

Acree Lisa Osaguona Osa

Aldaco Emie Maria Alban

Andrews Rachel Marlon Fisher

Applegate Michael William Mcalvany

Austin Nateka Amy Blanchard

Bailey Jean Sreevalli Dega

Barber Charlton Asif Qadri

Barnes Felecia James Collins, Jr.

Barrow Michael Eugene Sun

Beckett Davies Summer Forrest Toca

Berg Shawna Fredrick Makori

Black Jennifer Glenn Parris

Bonner Holly Madhusudan Chandora

Brown Robert Wael Alijishi

Caddell Casey Armando Castillo Jr.

Cadet Brigitte Manivannan Veerasamy

Caoile Michael Loan Vu

Carroll Dana Yusef Williams

Chmiel Edyta Lee Jacobs

Culpa-Bondal Maria Angela Dawson



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D'Annunzio Shannan Marwan Kazimi

Davila Teresa Wael Alijishi

Dixon Krystle Larry Smith

Dowden Phyllis Alexis Atwater

Drogoul Anastasiya Saad Hammid

England Kayla Christopher Randolph

Evans Eboni Garland Martin

Fajardo Judy Srilatha Nadipineni

Fincher Miranda Salvatore Assorgi

Flynn Adam Jeffrey Lowery

Fortenberry April Heather Ford

Francis-Freckleton Nicole Shanker Unnikrishnan

Franklin Scott Xing Gao

Fullard Nicole Salvatore Assorgi

Fuller Megan Mark Fugate

Fults Selvi Ryan Borst

Genas Kenesia Tiffany Parks

Giarla Kathleen Joshua Jackson

Giles Natasha Mehmood Mehdi

Green Faqueta Wayne Denton

Grove Misty Robert Hanrahan

Grove Misty Wael Alijishi

Grovenstein Evan Lonnie Sipsy

Haddad Amanda Karen Baker

Harris Valesha Gustavo Pradilla

Harris Valesha David Adamson

Harrison Jessica Michael Boggs

Harrison Tanya Lanashia Wells

Haskin Justin Steven Powell

Hawkins Rebekah Daniel Gordon

Heath Ashleigh Gabriela Pena

Henry Sherre Aderajew Taddesse

Herrin Lauren Atul Devani

Holbrook Feather Kanwar Gill

Hughes Michael Heather Hall

Jackson Ashley Ramanpreet Dhindsa

James Lequawn Michael Moody

Jiles Sierra Gehrig Harris, Jr.

Jones Morgan Norvin Ona

Jones-Harris Juanita Meesha Gwan-Nulla

Kell Kayla Charles Gomez



21


King Jillian Christopher Inhulsen

Kirkland Halei Salvatore Assorgi

Kosenski Butts Kira Audrey Henson

Any Old/New Business

The Committee discussed the FAQ’s and the changes that are forth coming.

PHYSICIAN ASSISTANT ADVISORY COMMITTEE Dr. Antalis presented the Physician Assistant Committee report.


Approved the following applications for initial licensure with a supervising physician:

PA Supervising Physician

Taylor Abu-Alrub Shalabh Chandra

James Aksamit Jonathan Sevransky

Jaymie Bailey Hunter Champion

Hallie Bain Martin Hardy

Jessica Baum Scott Barbour

Faith Boone Laurence Busse

Megan Boswell-Betts Franklin Harkrider

Robert Bowen John Sapp

Morris Chemell Steven Magilen

Bailey Dickinson Jay Goldstein

Marc DiFronzo Vlastimil Smetka

Joseph Ferguson Yetunde Orimogunje

Gabriella Goldberg Vikram Sabarwal

Justin Hamil Lansing Hillman

Alexis Hess Dana Kumjian

Mary Horne Waseem Ghannam

Christine Landgren Lee Kelly

Tiwana Miller Tamar Jackson

Mary Peabody Timothy McCullough

Devin Perry Ahmad Mohammad

Samuel Roberts Keith Lamberson

Dar Robinson Emily Lagergren

Cierra Ryan Jean Koff

Dillon Veal Jerry Mullis

James Weegar Waseem Ghannam

Approved the following applications for initial licensure without a supervising physician:

PA

James Akins

Rabail Altaf



22

Douglas Amis

Lauren Anderson

Enoch Asiedu

Jenna Ashton

Adewumi Bakare

Brian Baldwin

Jeremy Bass

Alemtsehay Bayyan

Katherine Browne

Courtney Calote

David Conn

William Crunk

Mitchell Daniel

Grace Fantl

David Goins

Emma Goldman

Giovanna Golem

Kaitlin Hagan

Nicole Hall

Kimberly Harvey

Erin Hembree

Sarah Inglesby

Marc Marchioli

McKenna Moe

Brittany Moon

Emily Morris

Claire Murphy

Nadege Nerette

Brandon Nieves

Nili Nourpavvar

Madison O’Brien

Karja Peart

Polina Rubin

Natalie Schoeffler

Thomas Sheridan

Brandon Smith

Megan Srongprapa

Lance Stephens

Pooja Unjiya

Ryan VanderMark

Kelly Stevens

Approved the following applications for licensure reinstatement with a supervising physician:


Chelsea Stoever James Stoever

Kara Whyte Harry Wingate



23

Approved the following applications for additional duties:

David Alexander- Michael Hardee

Stress Tests

Cheyne Charles- Gagandeep Joshi

Stress Tests

Brandi Eaton- Jeff Donohue

Pellets

Caleb Etheridge- Mark Floyd

Shoulder Injections

Hip Injections

Trochanteric Injections

Knee Injections

Lauren Fisher- Melissa Babcock

Chemical Peel TCA

Kybella Cosmetic Injections

Neurotoxin Injections

Dermal Filler Injections

Hannah Galvan- Deepa Patel

Central Lines

Intubation

Arterial Lines

Colleen Hill- Sara Auld

Intubation

Arterial Lines

Central Venous Catheter

Nives Keron- Amelia Langston

Bone Marrow Biopsy

Emily LeCraw- Alexandra Feliciano

Aesthetic Injection

Kenneth Phelps- Robert Kim

Medical Liver Biopsy

Allison Smith- Michael Bosley

Paracentesis

Thoracentesis

Port Placement

Moderate Sedation



24

Andrew Woodham- John W. Barton

Port Catheter Removal

Anthony Ambrose- Sachin Lavania

Paracentesis

Thoracentesis

Chest Tube Insertion

Intubation

Collen Hill- Sara Auld

Paracentesis

Thoracentesis

Chest Tube

Other Business:

Tatjana Cotta-Connors

Email Response Received: April Board Recommendation - 240 Shadowing Hours

Answer: Permitted to table application and resubmit at later date.

Nitasha Burney-Fleming

Email Response Received: Request for Clarification

Answer: PA responsible to notify the board regarding new alternate physicians. Submit AC1 form.

GCMB (Proposed Statement/Policy)

240 Shadowing Hours Frequent Questions

Answer: (1) Yes, prior shadowing hours may be included. (2) Reference letters from previous

supervisors must be current, no more than three years old; permitted to use colleagues but must be

MD/MO. (3) Shadowing supervisor would need to sign off on all performed duties when obtaining

required clinical hours. (4) No, current CME hours (80) have not met standard.

GCMB (Alternates/AC1 Processing/Postings)

Answer: Table to June board meeting for further discussion.

Approved the following Add/Change applications:


Julie Abrahamson Contessa Metcalfe

Jordan Aigner Stuart Lehn

Marissa Akin David Katz

Ramon Alarcon Vandy Garrney, II

Joseph Alfera Mark Firth

Shelina Arnold Joshua Hammond

Cristina Baldassarri Bhavik Shah

Morgan Baker Jan Mayfield

Margarete Bane William Dozier



25

Tara Barton Robert Deal

Negin Bauer Eric Nelson

Stephen Benton Srikant Nannapaneni

William Benz Heywood Gay

Kathryn Berman Barry Renz

Easton Beshears Ronnie Hendriz

Nicole Black Abhik Dahr

Ashley Boachie-Adjei Carmen Kavali

Elizabeth Bonin Charles Leewood

Deborah Bowman Robert Dourron

Bradly Bowser Justin Carroll

Cynthia Brand Donald Browning

Charle Cameron Bennie Brown

Liz Chapman Bisan Salhi

Amanda Cornwell Dodd, Richard

Kinsley Cowart Rebecca Lopez

Kinsley Cowart David Schmidt

John Cox, Jr. Woody Francis

Thomas Cox Daquesha Chever

Victoria Coyne Christa Jillard

Sarah Craven Christina Wu

Amanda Culbertson Alan Farabaugh

Amanda Culbertson David Powell

Bartlett Davis Loy Cowart

Bartlett Davis Glen Bunn

Henry Davis George Cierny

Phuong Dinsfriend Amit Singh

Amy Duane Olufunke Orimagunje

Gary Dutka Michael Hamm

Christine Ertley Neela Natarajan

Olufunke Fadoju Karla Booker

Joy Ford Jacqueline Harris

Meredith Foushee Sara Friend

Meredith Fox Christina Rich

Megan Gaines Jeffrey Goldberg

Hannah Galvan Deepa Patel

Rachel Garner Joe Huong

Sonthonax Gay Radhwan Alrubaye

Janai Gibson Mitzie-Ann Davis

Andrew Goodner Andrew Klein

Allison Gosnell Michael Maceroli

Kellly Graham Jin Park

Shawnna Greco Dev Mangalat

Thomas Greene Kenneth Benjamin

Leah Gumucio Cassie Campbell

Rebecca Habte Jason Burch

Patricia Hagerman Rene Latoni



26

Bibi Haniff Melvin Echols

Vaban Harris Krupa Desai

Nathan Hayden Michael Duggan

Kristen Healy Thinh Nguyen

Colleen Hill Sara Auld

Alexandra Hodson Venu Velagapudi

James Hunter Mala Kaul

William Hutcheson Robert Pilcher

Stephanie Hyson-Guevara Amber Orquia

Brian Jamail Lindsay Dowis

Robert Jones Ajay Handa

Jackie Kennedy Patricia Evans

Nives Keran Amelia Langston

Rebecca Klisovic Yevgeniya Berkovski

Michelle Kowal Jeffery Gladstein

Wendi Kretzschmar Peter Kim

Justin Kwon Shawn Kim

Emily LeCraw Alexandra Feliciano Aponte

Julie Lovelly Allison Ventura

Aaron Morton Mark Cardi-Scheible

Samuel Muller Jamil Muhammad

Nhung Nguyen Joe Huong

Brett Puckett Kellie Middleton

Hilliary Rounds Allison Ruch

Chereese Rowe Letty Peterson

Brandy Scott Richard May

David Wade Gonzalo Villalobos

Justin Vinomon Daniel Carothers

Nicole Rivera Neal Patel

Erica Pena Muhammad Usman

Carla Perry-Davis Muhammad Usman

Courtney Rejzer Daquesha Chever

Ava Tompkins William Benedict

Milajurine Lindsay Fred Kennard

Dhara Patel Reginald Strother

Priya Patel Shirley Harris

Angela Scarboro Yulianty Kusuma

Wallace Torbert Riliwanu Aliu

Trenton Moore Kris Manlove-Simmons

Shivani Patel John Lawrence

Shawna Silverman Deronda Brown

Frankie Walls Martha Shuh

Paul Schofield Stephen White

Brandon West Gena Volas-Redd

Renee Wright Julie Crusor

Haley O’Reilly Christina Wu

Patrick Murray Michael Duggan



27

John Pena Stephen Skidmore

Jared Robinson Richard Shack

Emily Shull Ansa Anderson

Questa Tingler Catherine Dickens

Madison Wickline Siddharth Patel

Salihu Yarima Raymond Sykola

Kianna Lawson Allison Ventura

Cody Leatherwood Kathryn West

Reagan Marienga Onkar Khullar

Kyle McGovern Allison Ventura

Rachel Metz Darrell Scales

Melissa Pietro Enrique Martinez

Isabel Soles Gabriela Pena

Sara Stephano Andrew Ostrowski

Megan Tunstill Carmen Mays

Christina York Jason Burch

Brittany Swicegood Arthur Chandler

Jarrod Luttjoham Gerald Filmore

Skyler Lamberth George Vijia

Erin Love Kim Peter

Joseph Nyankum Martha Crenshaw

Jeremy Palmer Afolarin Banjoko

Michael Shibley Frederiek Turton

Adam Wyble Patricia Evans

Lauren Upchurch Mara Schenker

Ericka Ravenell Mark Lelli

Alissa Traina Stephen Skidmore

Kolyse Wagstaff Alexis Shaffer

Andrea Ledbetter Maan Jokhadar

Scott Lewis Lissa Murphy

Sharon Masinelli William Dinsfriend

Jennifer Miller Stuart Lehn

Trisoni Miller Kenneth Grotz

Meagan O’Brien Naima Cheema

Lisa Piper Heather Horton

Brett Scoggins Joshua Hammond

Ian Thomas Michael Nordsiek

Lauree Thomas Seth Eisenberg

Keisha Wilkerson Amit Singh

Jean Lee Franklin Harkrider

COSMETIC LASER ADVISORY COMMITTEE Dr. Gross presented the Cosmetic Laser Committee report as a motion and it carried unanimously.




28

Approved the following for Assistant Laser Practitioner –

Taylor Benning

Grecia Camacho

Marsha Charles

Sadie Colan

Kelly Eleazer

Samantha Hammond

Demetrius Hull

Shona Jackson

Cindy Lambros

Linsey McCarthy

Malea Moore

Liliana Perea-Gallego

Kaylee Pirtle

Vivian Carole Reddick

Desiree Riera

Kimberly Roelofs

Meirielly Teixeira

Allik Townsend

Huyen Tran

Sheniqua Mary Turner

Approved the following for a reissue of Assistant Laser Practitioner –

Kalen Wheeler

Approved the following for Senior Laser Practitioner –

Elizabeth Beringson

Pamela Lynn Brown

Eric Dennin

Approved the following for a reissue of Assistant Laser Practitioner pending additional information

L.L.

Other Business:

The Board requested the following assistant laser practitioners (licensed at the March 4, 2021

meeting) refrain from laser practice until the GA RN license is issued.

ML

BS

The Board recommended that for questions regarding micro-needling by estheticians or cosmetologists,

from Natalie Majeed should review OCGA 43-10-1 for the regulations for the practice of estheticians

and master cosmetologists. If the specific information cannot be found, she should consult her own legal

counsel. For questions regarding ablative laser procedures, the following practitioners can perform:

Licensed physicians; licensed physician assistants with a Board-approved Basic Job Description and

additional duty request; and licensed nurse practitioners with a Board-approved nurse protocol

agreement and Form C with additional procedures.



29

Erika Rose and Patrick Burns demonstrated the Futura Face device. The Board reversed a previous

decision and determined that the operator for this device would not require a cosmetic laser practitioner

license.

RESPIRATORY CARE ADVISORY COMMITTEE Dr. Dalton presented the Respiratory Care Committee report as a motion, seconded by Dr.

Retterbush. The Board accepted the report by unanimous vote.


Correspondence:

• Email question from Crystal Dawn regarding scope of practice for RRTs and transport RRTs. The

Committee determined the Medical Director will advise accordingly depending on program for

transport teams.

• Email question from Sandra Jacobs regarding hiring RT students prior to graduation. The Committee

determined Ms. Jacobs should refer to rule 360-13-.12(2)(h).

Practicing without a license; fine and consent order

Burgess, Claude

Reinstatements:

Bressler, Denise

Merriweather, Keneshia

Alemu, Ermias

Kizziah, Stacie

Wood, Whitney

Yisrael,Yosef

Musa, Ayub

Harris,Leonna

Brunson, Arthur- pending additional information

Temporary Licensure; - pending additional documentation

Sodemann, Gretel

Johnson, Kedra

Lesesne, Kiah

Edwards, Alicia

Regmi, Karuna

Wiley, Yatasha

Finley, Leah

Temporary Licensure; Gwinnett Technical College; pending Form A

Choudhury, Tuly

Ashong, Josephine

Utley, Steven

Yara, Tomokazu

Young, Shanikko

Long, Brittany

Nguyen, Nghi



30

Agbomson, Mianken

Abuajah, Terrence

Keyhan, Maryam

Basha, Emma

Brownwest, Asaye

Dang, Thuy

Crespo Bezares, Marlette

Hines, Lakeisha

Harter, Hope

Jeanty, Antonio

Jagroo, Nadia

Yun, Yamada

Temporary Licensure; Middle Georgia State University; pending Form A

Dixon, Courtney

Coleman, Hannah

Allen, Jasmine

Appiah, Ashley

Quayson, John

Walker, Mi’Kela

Whatley, Jacob

Marrone, Danielle

Temporary Licensure; Columbus Technical College; pending Form A

Jenkins, Tyrel

Neisent, Jonathan

Berry, Jessica

Booker, Leeia

Bailey, Heidi

Delly, Clinton

Full Licensure:

Adams, Tabatha

Clark, Rodney

Garrick, Amanda

Hancock, Derrick

James, Kayla

Pace, Felecia

Ross, Elizabeth

Turner, Felecia

Dickinson, Allison

Jackson, Garnette

Skoe, Teresa

Gilbert, Leah

Brown, Kimberly

Crosthwaite, Christy

Grayson, Timothy



31

Harris, Bria

Jenkins, Kaitlin

Moran, Ashley

Paff, Amy

Runels, Laurel

Williams, Jacqueline

Corbin, Austen

Nelson, Maranda

Keeling, Ashley

Bowen, Sheryl

Atkins, Michele

Griffin, Lisa

Holmes, Mallory

Moss, Sandaireca

Palmisano, Jennifer

Stallworth, Brittania

Pedigo, Karrie

Greene, Barbara

Waldroop, Debbi

Howard, Michelle

McCallum, Detaurius

Barimah, Jasmine

Carter, Dyonna

Frink, Adam

Placide, Ashley

Wooten, Bailee

Massaley, Hawa

Guy, Diane

Bickel, Jennifer

Cassidy, Jonathan

Garrett, Latrice

Hamilton, Nicholas

Hull, Terence

Merrick, Ashley

Newland, Crystal

Reed, Pandora

Thomas, Lavellie

Wright, Amanda

Young, Melanie

Cleare, Ronesha

Karjala, Lindsey

King, Rochelle

Pitts, Amy

Hawkins, Erin

Cooper, Dyamond- pending additional documentation

Dalton, Pindell- pending additional documentation

Brown, Domanique- pending additional documentation



32

Almakrami, Abdulaziz- pending additional documentation

Dodson, Valerie- pending additional documentation

Freeman, Marcella- pending additional documentation

Hall Shanda- pending additional documentation

Stinger, Joyce- pending additional documentation

Administrative Upgrades

Brooke Okorley

Benjamin Giraud

Erica Armstrong

Promise Garner

Delaney Bell

Nerixa Portillo

Timothy Hester

Jessica Watkins

Paulos Weldegiorgis

Justin McNair

Kayla Roscoe

Andrea Scott

Natasha Dixon

Yury Garcia

Cassidy Callahan

Angeline Mamaril

Carlos Wong

Jackie Anderson

Matthew Rice

Aqsa Iqbal

Qui Phan

Cherry Bryant

Amelia Robinson

Kathryn Lowe

Pamele Trujillo

Alexis Brent

Christopher Owen

Kimberly Henson

Yilak Assefa

Carol Taylor

Matthew Crockett

Hailey Wright

Brian Calizo

Michaell Choi

Aja Lippitt

Suzan Alsanoussi

Josephina Addo

Nicole Gaston-Howard

Chelsei Poole

Alyssa Johnson



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William Couse

Amber Prickett

Kisha Robinson

Deidra Mathis

Christina Montgomery

Lisa Flood

Quinetrious Thomas

PERFUSION ADVISORY COMMITTEE Dr. Retterbush presented the Perfusion Committee report as a motion and it carried unanimously.


Approved the following for Initial Perfusion Licensure:

Brittany Miller

ACUPUNCTURE ADVISORY COMMITTEE Dr. Bostock presented the Acupuncture Committee report as a motion and it carried unanimously.


Accepted the following quarterly reports:

Abigail Hurewitz

Lu Phoun

Janna Torontali

Approved the following for limited acupuncture licensure:

Michelle Arms

Byeonghong Cho

Approved the following for initial acupuncture licensure:

James Kelsey, Jr

Kyungja Yun

Michelle Zamora

Other Business:

The Board accepted as information the list of limited licensees and supervisors.

The Board determined that an acupuncture licensee may see and treat patients in their home provided the

licensee’s insurance carrier approves and that local statutes regarding residential areas are followed.

PAIN MANAGEMENT COMMITTEE Dr. Collins presented the Pain Management Committee report as a motion. The Board accepted

the report by unanimous vote.



34


Correspondence:

• Question from Timothy Ward, MD regarding current state policy on prescribing/refilling

Schedule II medication within 90-day period. The Board determined Dr. Ward should

refer to rule 360-3-.06(2)(f).

• Question from Ty Williams-King regarding whether Dr. Rasean Hodge’s can continue

treating patients via online. The Board determined Dr. Hodges’s should continue to

comply with rules previously set forth.

Approved the following applications:

Pain Clinic Name

Alliance Spine and Pain Centers- Dacula

Summit Spine & Joint Centers- Marietta

Summit Spine & Joint Centers- Rome

Lic # 387 Summit Spine & Joint Centers-Decatur

ADD Physician, Jose Mathew

ADMINISTRATIVELY APPROVED APPLICATIONS

License # Pain Clinic Name

185

Rehabilitation Physicians of Georgia, PC

ADD PA, Helen Zhang

224

Harbin Clinic, LLC

ADD APRN, Courtney Hann

379

Duluth Medical Center, LLC

ADD Practicing Physicians, Bradford Gould & Muhammad Usman

412

Summit Spine & Joint Centers

ADD Practicing Physician, Chad Lee

530


ADD Practicing Physician, Thomas Cheriyan

377, 411


ADD APRN, Deborah Wilkens

ADD Practicing Physician, Gabriel Marrero

473


ADD Practicing Physicians, Thomas Cheriyan, Adam Gover, and Srinand

Mandyam

258

Summit Spine and Joint Centers

ADD Practicing Physicians:



35

Gerald Chai, Thomas Cheriyan, An Duy Do, Adam Gover, Gabriel Marrero

ADD PA Scott Linacre

ADD APRNs, Dalandra Belcher, William Wikoff & Deborah Wilkens

447, 465

Spectrum Spine and Pain Care

DELETE Practicing Physician, Simon Willis

410


ADD Practicing Physicians,Thomas Cheriyan, and Amod Sureka

ADD APRNs, Dalandra Belcher and William Wikoff

504, 512


ADD APRN, Chenoa Dickerson

153

Pain Management and Wellness Center

DELETE Practicing Physicians, David Katz, Naureen Adams, and Victor

Leslie

153

Pain Management and Wellness Center

ADD Practicing Physician, Richard Campbell

533

Spine and Orthopedic Center

DELETE Practicing Physician, Pran Nath Sood

195

Care Medical Center

ADD APRN, Fran McPherson

Other Business:

The Board decided the staff will include a face sheet on the Renewal Form explaining the consequences

of falsifying questions on the form.

GENETIC COUNSELORS ADVISORY COMMITTEE

Dr. Deloach presented the Genetic Counselors Advisory Committee report.


Draft Separation Notice

Motion Ms. Bellcross, seconded Ms. Brickle and motion carried to approve the new form.

CGC Examination Information

Ms. Bellcross made the Committee aware of changes the CGC Examination has made. The Committee

tabled the discussion until the June meeting to allow everyone an opportunity to review the changes and

to see if these changes will impact the current rules.

The following applications were approved:

Brittany Hansen

Divya Abraham

Katherine Agre



36

Colleen Blanchard

Lauren Bogue

Chloe Dugger

Brittany Hansen

Emily Hendricks

Julie Moroney

Ami Narayen

Haley Pace

Rachel Reaglee

Amanda Roth

Audrey Schlachter

Grace Tan

Nicole Wengrofsky

The following application is approved pending additional information:

Rachael Cabey

There was a question on the online form, if there was a limited number of employment items that can be

added to the application? The staff will follow up and let the Committee know.

LAW ENFORCEMENT ADVISORY REPORT

The LEAR report was presented as a motion by Dr. Marshall and was seconded by Dr. Harbin. The

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

1. 20162317 - Deny Request

2. 20201264 - Release information



5. 20210065 - Approve

6. 20180433 - Deny Request

7. 20210098 - Refer to Law Enforcement

8. 20210292- Refer to Law Enforcement


INVESTIGATIVE INTERVIEW REPORT Dr. Retterbush, presented the Investigative Interview report as a motion, and was seconded by Dr.

Collins. The Board took the following actions.

20180676 Close 20200608 Referred to AG’s Office

20200166 Letter of Concern 20201094 OMPE

20201265 Close 20201389 Close

20201404 Letter of Concern 20201485 Further Investigation

20210325 Close 20210455 Referred to AG’s Office



37

INVESTIGATIVE COMMITTEE

The Investigative Committee report was presented as a motion by Dr. Harbin and was seconded by Dr.

Marshall. The Board accepted the report by unanimous vote. The Board accepted the report majority vote

with E. Daniel DeLoach, MD only opposing 20191727. The Board took the following actions.

The Board took the following actions.

Close:

20111962 20160548 20170406 20170856 20180137 20181381

20181655 20181703 20190039 20190192 20190588 20190901

20191713 20191715 20191968 20192349 20192371 20192384

20192399 20192461 20192506 20200036 20200515 20200957

20200993 20201000 20201041 20201179 20201374 20201447

20210077 20210116 20210218 20210234 20210268 20210403

20210462 20210509 20210529 20210609 20210699 20210769

20210813 20210824 20210861 20210876 20210889 20210908

20210909 20210910 20210913 20210918 20210939 20210940

20210953 20210973 20210976 20210981 20210985 20210991

20210998 20211096 20211157 20211222 20211237 20211255

20211277

Letter of Concerns:

20190701 20190789 20190917 20200206 20200653 20201571

20201611 20201618 20210176 20210247 20210465 20210521

20210682 20210782 20210863 20210866 20210871 20210883

20210899

Further Investigation:

20201090 20210358

Invite for Investigative Interview:

20210963 20201148 20201536 20210083 20210547 20210900

20210911 20210912 20210205

Table

20210765 20211168 20211221

Referred to Attorney General’s Office

20192393 20192412 20200457 20200475 20210354 20210405

20210435 20211139 20211165 20191727 20201176

Peer Review



38

20210963 20182021 20200802 20200964 20201421 20210954

20210377

INITIAL COMPLAINT EVALUATIONS The Board approved the following recommendations.

20210917 20211120 20211123 20211126 20211154 20211158

20211169 20211175 20211180 20211181 20211184 20211188

20211189 20211191 20211200 20211210 20211215 20211220

20211225 20211227 20211256 20211272 20211274 20211283

20211285 20211299 20211315 20211318 20211241 20211049

RECUSALS

Bostock 20210205 20201176 20182021

Dalton 20210765 20210954

DeLoach 20210765

Marshall 20210765

Reisman 20210765

There being no further business, motion Dr. Marshall, seconded Dr. Harbin to adjourn the meeting at

4:13p.m.

__________________________________ ________________________________

Barby J. Simmons, DO LaSharn Hughes, MBA

Chairperson Executive Director

Recorded by:

________________________________________ Phyllis White, Executive Assistant

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