Clinical Registrant Phase II Applicant Information...Andrew Nikolaus Dodge Managing Director, Ecore...
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Clinical Registrant Phase II Applicant Information PA DOH Page 1 of 23 June 19, 2019 Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR01 Laurel Harvest Labs LLC Temple University Andrew N. Dodge 717-917-8556 [email protected] Source: Clinical Registrant application section 1 & 2 Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR01-D19-1201 Laurel Harvest Labs LLC Southeast Limited Liability Company 119 South Tree Drive Lancaster PA 17603 717-917-8556 [email protected] Source: Dispensary application section 1 & 18 Dispensary Facility Information* Primary Name Primary County Second Name Second County Lackawanna Montgomery Source: Dispensary application section 2 Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Andrew Nikolaus Dodge Managing Director, Ecore International President/Chief Operating Officer Nicholas Karalis R.Ph. Chief Executive Officer, Elwyn Pharmacy Group Chief Executive Officer Mitchell Bryan Baruchowitz Esq. Managing Partner, Merida Capital Partners Chief Marketing Officer Glenn Curtis Taylor Member, Board of Governors Chief Financial Officer Scott Eric Rosenthal D.O., P.C. Physician, Pinnacle Pain Management Chief Medical Officer Michelle Athanas Karalis R.Ph. Founding Member, Tetra Rx Chief Pharmaceutical Officer/Chief Diversity Officer Therese Marie Mellet Chief Administrative Officer, Merida Capital Partners Chief Administrative Officer Sunshine Liberty Brosi PhD Professor, Biology Department, Frostburg State University Chief Scientific Officer Source: Dispensary application section 20 * Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Transcript of Clinical Registrant Phase II Applicant Information...Andrew Nikolaus Dodge Managing Director, Ecore...
Clinical Registrant Phase II Applicant Information
PA DOH Page 1 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR01 Laurel Harvest Labs LLC Temple University Andrew N. Dodge 717-917-8556 [email protected]
Source: Clinical Registrant application section 1 & 2
Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR01-D19-1201 Laurel Harvest Labs
LLC Southeast Limited Liability
Company 119 South Tree Drive Lancaster PA 17603 717-917-8556 [email protected]
Source: Dispensary application section 1 & 18
Dispensary Facility Information* Primary Name Primary County Second Name Second County Lackawanna Montgomery
Source: Dispensary application section 2
Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Andrew Nikolaus Dodge Managing Director, Ecore International President/Chief Operating Officer
Nicholas Karalis R.Ph. Chief Executive Officer, Elwyn Pharmacy Group Chief Executive Officer
Mitchell Bryan Baruchowitz Esq. Managing Partner, Merida Capital Partners Chief Marketing Officer
Glenn Curtis Taylor Member, Board of Governors Chief Financial Officer
Scott Eric Rosenthal D.O., P.C. Physician, Pinnacle Pain Management Chief Medical Officer
Michelle Athanas Karalis R.Ph. Founding Member, Tetra Rx Chief Pharmaceutical Officer/Chief Diversity Officer
Therese Marie Mellet Chief Administrative Officer, Merida Capital Partners Chief Administrative Officer
Sunshine Liberty Brosi PhD Professor, Biology Department, Frostburg State University
Chief Scientific Officer
Source: Dispensary application section 20
* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Clinical Registrant Phase II Applicant Information
PA DOH Page 2 of 23 June 19, 2019
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR01-GP19-1201 Laurel Harvest Labs, LLC Southeast Limited Liability
Company 119 South Tree Drive Lancaster PA 17603 717-917-8556 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality 279 South Barbara Street Mount Joy 17552
Lancaster Mount Joy Borough
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Andrew Nikolaus Dodge Managing Director, Ecore International President/Chief Operating Officer
Nicholas Karalis R.Ph. Chief Executive Officer, Elwyn Pharmacy Group Chief Executive Officer
Mitchell Bryan Baruchowitz Esq. Managing Partner, Merida Capital Partners Chief Marketing Officer
Glenn Curtis Taylor Member, Board of Governors, Leafline Labs LLC Chief Financial Officer
Scott Eric Rosenthal D.O., P.C. Physician, Pinnacle Pain Management Chief Medical Officer
Michelle Athanas Karalis R.Ph. Founding Member, Tetra Rx Chief Pharmaceutical Officer/Chief Diversity Officer
Therese Marie Mellet Chief Administrative Officer, Merida Capital Partners Chief Administrative Officer
Sunshine Liberty Brosi PhD Professor, Biology Department, Frostburg State University
Chief Scientific Officer
Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 3 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR02 CannTech PA, LLC Lake Erie College of
Osteopathic Medicine (LECOM)
Danielle Alvarez Wolf, Esq. 908-764-8286 [email protected]
Source: Clinical Registrant application section 1 & 2
Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR02-D19-6701 CannTech PA, LLC Northwest Limited Liability
Company c/o Eckert Seamans Cherin & Mellott, LLC, 213 Market Street, 8th Floor
Harrisburg PA 17101 908-764-8286 201-533-0701 [email protected]
Source: Dispensary application section 1 & 18
Dispensary Facility Information* Primary Name Primary County Second Name Second County Third Name Third County Fourth Name Fourth County Fifth Name Fifth County CannTech Fairview Dispensary
Erie CannTech Norristown Dispensary
Montgomery CannTech Bensalem Dispensary
Bucks CannTech Gibsonia Dispensary
Allegheny CannTech Harrisburg Dispensary
Dauphin
Source: Dispensary application section 2
Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business John Tarik Bey PAANG, Superintendent, Comptroller Office President, Treasurer, PA Chief Security Officer
Hannah H Iglesias Paralegal Compliance Officer
Madhevan Palpu Asokan Cannabis Horticulturist Chief Horticulturist
Alex R. Collins Director of Products Manufacturing Director of Product Development
Sean Band Cannabis Horticulturist Director of Cannabis Horticulture
Paul Austin Higdon II Law enforcement (retired DEA and INTERPOL)
National Chief Security Officer
Kemel W. Dawkins Financial Consultant CEO
Aaron Jason Epstein Esq. Attorney, Dispensary Manager Chief Operating Officer
Min Chu Ph.D. Chemist Chief Scientific Officer
Edward Marvin Miller MD Physician; hospital administrator Chief Medical Officer
Clinical Registrant Phase II Applicant Information
PA DOH Page 4 of 23 June 19, 2019
First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Susan Taylor MD Physician Chair of Medical Advisory Board; Chairman of the Board of
Managers Danielle Y. Alvarez-Wolf Esq. Attorney Chief Legal Officer; Secretary
Source: Dispensary application section 20
* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Clinical Registrant Phase II Applicant Information
PA DOH Page 5 of 23 June 19, 2019
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR02-GP19-5701 CannTech PA, LLC Southwest Limited Liability
Company c/o Eckert Seamans Cherin & Mellott, LLC, 213 Market Street, 8th Floor
Harrisburg PA 17101 908-764-8286 201-533-0701 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality CannTech PA, LLC Medical Marijuana Grower/Processor Facility
535 Keystone Drive Warrendale 15086 Allegheny Marshall Township
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business John Tarik Bey PAANG, Superintendent, Comptroller Office President, Treasurer, PA Chief Security Officer
Hannah H Iglesias Paralegal Compliance Officer
Madhevan Palpu Asokan Cannabis Horticulturist Chief Horticulturist
Alex R. Collins Director of Products Manufacturing Director of Product Development
Sean Band Cannabis Horticulturist Director of Cannabis Horticulture
Paul Austin Higdon II Law enforcement (retired DEA and INTERPOL) National Chief Security Officer
Kemel W. Dawkins Financial Consultant CEO
Aaron Jason Epstein Esq. Attorney, Dispensary Manager Chief Operating Officer
Min Chu Ph.D. Chemist Chief Scientific Officer
Edward Marvin Miller MD Physician; hospital administrator Chief Medical Officer
Susan Taylor MD Physician Chair of Medical Advisory Board; Chairman of the Board of Managers
Danielle Y. Alvarez-Wolf Esq. Attorney Chief Legal Officer; Secretary Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 6 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR03 Columbia Care Western PA, LLC University of Pittsburgh
School of Medicine Nicholas K Vita 978-735-2276 [email protected]
Source: Clinical Registrant application section 1 & 2
Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR03-D19-5601 Columbia Care
Western PA, LLC Southwest Limited Liability
Company 321 Billerica Road, Suite 204 Chelmsford MA 01824 978-735-2276 [email protected]
Source: Dispensary application section 1 & 18
Dispensary Facility Information* Primary Name Primary County 5th Avenue Pittsburgh Dispensary
Allegheny
Source: Dispensary application section 2
Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Nicholas Keane Vita Businessman CoFounder and CEO
Source: Dispensary application section 20
* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Clinical Registrant Phase II Applicant Information
PA DOH Page 7 of 23 June 19, 2019
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR03-GP19-2601 Columbia Care Western
PA, LLC Northeast Limited Liability
Company 321 Billerica Road, Suite 204
Chelmsford MA 01824 978-735-2276 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality Columbia Care Western PA LLC 100-106 Maplewood Drive Hazleton 18201 Luzerne Hazle
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Nicholas Keane Vita Businessman CoFounder and CEO
Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 8 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR04 Cansortium
Pennsylvania, LLC Philadelphia College of Osteopathic Medicine
Jose Javier Hidalgo, CEO 305-900-6266 [email protected]
Source: Clinical Registrant application section 1 & 2
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR04-GP19-3801 Cansortium
Pennsylvania, LLC Southcentral Limited Liability
Company 1150 First Ave, Suite 511
King of Prussia PA 19406 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality Cansortium Pennsylvania, LLC 433 Fikes School Road York Springs 17372 Adams Huntington
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Jose Javier Hidalgo
Henry Batievsky Chief Financial Officer CFO
Alberto Farinez Chief Operating Officer COO
Kanthysree Vaylvay Controller
Philip Sasso Medical Director
Jennifer McCafferty-Fernandez
Raveendranath Vaylay Chief Cultivation Officer Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 9 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR05 PA Options for Wellness,
Inc. Penn State College of Medicine Thomas Allen Trite 215-375-1584 [email protected]
Source: Clinical Registrant application section 1 & 2
Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR05-D19-1302 PA Options for Wellness,
Inc. Southeast C-Corporation 4711 Queen Avenue,
Suite 201 Harrisburg Pennsylvania 17109 717-467-4286 717-798-3901 [email protected]
Source: Dispensary application section 1 & 18
Dispensary Facility Information* Primary Name Primary County Second Name Second County PA Options for Wellness, LLC - Lancaster Dispensary
Lancaster PA Options for Wellness, LLC - Harrisburg Dispensary
Dauphin
Source: Dispensary application section 2
Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Thomas Allen Trite PD, FASCP Pharmacy Owner & Pharmacist Principal (Chairman & CEO, Chairman of Board of Directors &
Shareholder) Sonya Wilford Weigle Management Consultant Operator (President & Chief Strategy Officer, Member of the
Board of Directors) John Carmelo Spagnola R.Ph. Business Owner & Pharmacist Operator (Chief Operating Officer)
Carrie Louise DeLone M.D. Former Physician General for the Commonwealth of Pennsylvania
Principal (Chief Medical Officer, Chairwoman of the Medical Advisory Board & Shareholder)
Thomas John Arminio Retired Capt. US Navy Operator (Chief Security Officer)
Jahan Marcu Ph.D. Co-Founder & COO of IRCCMH (International Research Ctr. on Cannabis & Mental Health)
Operator (Director of Research & Quality Assurance)
Troy Lewis Wilford President, Keystone Life Sciences Operator (Vice President of Product Development)
Vincent Nazim Curtis CEO and Founder, American Proven Products, LLC
Director of Diversity & Community Services & Board Member
Clinical Registrant Phase II Applicant Information
PA DOH Page 10 of 23 June 19, 2019
First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business James Canby Byerly Chief Financial Officer - PaOFW Chief Financial Officer
Steven Thomas Auerbach Chief Compliance Officer- PaOFW Chief Compliance Officer
Tzuo Zen Lee Director of Operations-PaOFW Director of Dispensary and Manufacturing Operations
Pareg Patel Pharmacist Director of Dispensaries
Colleen Martin Director of Administration & Shareholder Director of Administration and Shareholder
Ivanhoe Smith Founder & Managing Director of Coral Island Group, LLC
Board Member
Richard Eugene Yingst President of Yingst Homes Financial Backer (Shareholder & Board Member)
Joseph Anton Williamson Chairman, President/CEO – Brandywine Senior Care, Inc.
Financial Backer (Shareholder & Board Member)
Mark Alan Szilagyi CEO – Gateway & Paoli Pharmacy Financial Backer (Shareholder)
Henry Michael Katra Co-Owner & VP Gateway Pharmacy Financial Backer (Shareholder)
Richard Robert Speranza VP & Secretary – Hubco Health Care Group LLC
Financial Backer (Shareholder)
Margaret Susan Ciccone Retired RN Financial Backer (Shareholder)
Edmond Daniel Costantini Jr. CEO & CFO – Greendrop LLC Financial Backer (Shareholder)
Frederick Martin Liddell President of Geo. Weaver & Son Moving Company
Financial Backer (Shareholder)
Carol Ruth Yingst Medical Assistant – Penn State Health Financial Backer (Shareholder)
Scott Kevin Yingst Owner, Yingst Trucking Company Financial Backer (Shareholder)
Thomas H. Flowers CPA Managing Partner, Flowers & Flowers, LLC Financial Backer (Shareholder) and Landlord
Daniel Ralph Riso President, Coregroup Displays Financial Backer (Shareholder)
John Carlisle Peet III VP/General Counsel, LabWare Holdings, Inc. Financial Backer (Shareholder) Source: Dispensary application section 20
* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Clinical Registrant Phase II Applicant Information
PA DOH Page 11 of 23 June 19, 2019
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR05-GP19-3302
PA Options for Wellness, Inc. (PAOFW)
Southcentral C-Corporation 4711 Queen Avenue, Suite 201
Harrisburg Pennsylvania 17109 215-375-1584 717-798-3901 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality PAOFW Cultivation & Processing Facility
50 Perry Avenue, Business Campus One
Duncannon 17020
Perry Penn Township
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Thomas Allen Trite PD,
FASCP Pharmacy Owner & Pharmacist Principal (Chairman & CEO, Chairman of Board of
Directors, Shareholder) Sonya Wilford Weigle Management Consultant Operator (President & Chief Strategy Officer, Member of
the Board of Directors) John Carmelo Spagnola R.Ph. Business Owner & Pharmacist Operator (Chief Operating Officer)
Carrie Louise DeLone M.D. Former Physician General for the Commonwealth of Pennyslvania
Principal (Chief Medical Officer, Chairwoman of the Medical Advisory Board & Shareholder)
William Charles Kuss Director of Agronomy & Cultivation Operator (Director of Cultivation)
Thomas John Arminio Retired Capt. US Navy Operator (Chief Security Officer)
Jahan Marcu Ph.D. Co-Founder & COO of IRCCMH (International Research Ctr. on Cannabis & Mental Health)
Operator (Director of Research & Quality Assurance)
Troy Lewis Wilford President, Keystone Life Sciences Operator (Vice President of Product Development)
Vincent Nazim Curtis CEO and Founder, American Proven Products, LLC
Director of Diversity & Community Services & Board Member
James Canby Byerly Chief Financial Officer - PaOFW Chief Financial Officer
Steven Thomas Auerbach Chief Compliance Officer- PaOFW Chief Compliance Officer
Tzuo Zen Lee Director of Operations-PaOFW Director of Dispensary and Manufacturing Operations
Pareg Patel Pharmacist Director of Dispensaries
Colleen Martin Director of Administration & Shareholder Director of Administration and Shareholder
Clinical Registrant Phase II Applicant Information
PA DOH Page 12 of 23 June 19, 2019
First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Ivanhoe Smith Founder & Managing Director of Coral Island Group, LLC Board Member
Richard Eugene Yingst President of Yingst Homes Financial Backer (Shareholder & Board Member)
Joseph Anton Williamson Chairman, President/CEO – Brandywine Senior Care, Inc. Financial Backer (Shareholder & Board Member)
Mark Alan Szilagyi CEO – Gateway & Paoli Pharmacy Financial Backer (Shareholder)
Henry Michael Katra Co-Owner & VP Gateway Pharmacy Financial Backer (Shareholder)
Richard Robert Speranza VP & Secretary – Hubco Health Care Group LLC Financial Backer (Shareholder)
Margaret Susan Ciccone Retired RN Financial Backer (Shareholder)
Edmond Daniel Costantini Jr. CEO & CFO – Greendrop LLC Financial Backer (Shareholder)
Frederick Martin Liddell President of Geo. Weaver & Son Moving Company Financial Backer (Shareholder)
Carol Ruth Yingst Medical Assistant – Penn State Health Financial Backer (Shareholder)
Scott Kevin Yingst Owner, Yingst Trucking Company Financial Backer (Shareholder)
Thomas H. Flowers CPA Managing Partner, Flowers & Flowers, LLC Financial Backer (Shareholder) and Landlord
Daniel Ralph Riso President, Coregroup Displays Financial Backer (Shareholder)
John Carlisle Peet III VP/General Counsel, LabWare Holdings, Inc. Financial Backer (Shareholder) Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 13 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR06 Agronomed Biologics LLC Drexel University College of
Medicine Jonathan Cohn 610-656-8083 [email protected]
Source: Clinical Registrant application section 1 & 2
Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR06-D19-1103 Agronomed
Biologics LLC Southeast Limited Liability
Company 280 West Boot Road West Chester PA 19380 610-656-8083 [email protected]
Source: Dispensary application section 1 & 18
Dispensary Facility Information* Primary Name Primary County Agronomed Biologics Delaware
Source: Dispensary application section 2
Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Jonathan Cohn CEO, COO CEO, Principal
Andrew Michael Weiss Real Estate Developer/Investor Chief Operating Officer, Principal
Reinhold Thomas Barchet Co-founder Board Treasurer, Principal
Kumaril Bhargava Drug Development Director Merck /Business Development Chief Science Officer, Principal
Robert Eugene Pease CEO Board Chairman, Principal
Cleosie Kirkland Insurance and Financial Management Diversity and Inclusion Officer, Operator
Malik Majeed President, CEO, General Counsel General Counsel and Facilities Director, Operator
Michael L. Levin Physician Chief Medical Officer, Operator
Faisal Mohammed Faseehuddin CPA Chief Financial Officer, Operator
Craig McHugh Security Company Owner / Private Investigator SVP Business Development, Principal
Kimberly Anna Stuck Founder, Cannabis Consulting Quality Control and Compliance Officer, Operator
Clinical Registrant Phase II Applicant Information
PA DOH Page 14 of 23 June 19, 2019
First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Helena C Yardley Scientist Chief Research Officer, Operator
Raymond Angeli President and COO Director of Community Affairs and Chairman of Academic/Research Partnerships, Operator
Patricia Ann Haley Program Director Security Officer, Operator
Robert Pearson Roche Jr. President Chief Commercial Officer, Operator
Jeremy Hurevitz Kahn CEO Board Member, Principal Source: Dispensary application section 20
* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Clinical Registrant Phase II Applicant Information
PA DOH Page 15 of 23 June 19, 2019
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR06-GP19-1102 Agronomed Biologics LLC Southeast Limited Liability Company 280 W Boot Road West Chester PA 19380 (610) 656-8083 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality Agronomed Biologics GP 8th and Hinkson Streets Chester 19013
Delaware Chester City
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Jonathan Cohn Occupationally Disabled Consultant/Entrepreneur CEO
Robert Pease Executive Board Chairman
Jeremy Kahn Executive Board Secretary
Andrew Weiss Executive COO
Reinhold Barchet Executive Board Treasurer
Craig McHugh Podiatrist / Entrepreneur Board Member Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 16 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR07 Agronomed Biologics LLC The Perelman School of Medicine
at the University of Pennsylvania Jonathan Cohn 610-656-8083 [email protected]
Source: Clinical Registrant application section 1 & 2
Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR07-D19-1504 Agronomed Biologics LLC Southeast Limited Liability
Company 280 West Boot Road West Chester PA 19380 610-656-8083 [email protected]
Source: Dispensary application section 1 & 18
Dispensary Facility Information* Primary Name Primary County Agronomed Biologics Delaware
Source: Dispensary application section 2
Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Jonathan Cohn CEO, COO CEO, Principal
Andrew Michael Weiss Real Estate Developer/Investor Chief Operating Officer, Principal
Reinhold Thomas Barchet Co-founder Board Treasurer, Principal
Kumaril Bhargava Drug Development Director Merck / Business Development Chief Science Officer, Principal
Robert Eugene Pease CEO Board Chairman, Principal
Cleosie Kirkland Insurance and Financial Management Diversity and Inclusion Officer, Operator
Malik Majeed President, CEO, General Counsel General Counsel and Facilities Director, Operator
Michael L. Levin Physician Chief Medical Officer, Operator
Faisal Mohammed Faseehuddin CPA Chief Financial Officer, Operator
Craig McHugh Security Company Owner / Private Investigator SVP Business Development, Principal
Kimberly Anna Stuck Founder, Cannabis Consulting Quality Control and Compliance Officer, Operator
Clinical Registrant Phase II Applicant Information
PA DOH Page 17 of 23 June 19, 2019
First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Helena C Yardley Scientist Chief Research Officer, Operator
Raymond Angeli President and COO Director of Community Affairs and Chairman of Academic/Research Partnerships, Operator
Patricia Ann Haley Program Director Security Officer, Operator
Robert Pearson Roche Jr. President Chief Commercial Officer, Operator
Jeremy Hurevitz Kahn CEO Board Member, Principal Source: Dispensary application section 20
* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Clinical Registrant Phase II Applicant Information
PA DOH Page 18 of 23 June 19, 2019
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR07-GP19-1503 Agronomed Biologics LLC Southeast Limited Liability Company 280 W Boot Road West Chester PA 19380 (610) 656-8083 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality Agronomed Biologics GP 8th and Hinkson Streets Chester 19013
Delaware Chester City
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Jonathan Cohn Occupationally Disabled Consultant/Entrepreneur CEO
Robert Pease Executive Board Chairman
Jeremy Kahn Executive Board Secretary
Andrew Weiss Executive COO
Reinhold Barchet Executive Board Treasurer
Craig McHugh Podiatrist / Entrepreneur Board Member Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 19 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR08 MLH Explorations, LLC Sidney Kimmel Medical College
at Thomas Jefferson University David Clapper 610-896-3004 [email protected]
Source: Clinical Registrant application section 1 & 2
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR08-GP19-1404 MLH Explorations, LLC Southeast Limited Liability
Company 308 E. Lancaster Ave., Suite 300
Wynnewood PA 19096 610-896-3000 610-862-3917 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality Solterra Care Grow/Process Facility 150 Roebling Road Fairless Hills 19030
Bucks Falls Township
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business William Landman Principal, Mainline Investment Partners Financial Backer, Principal (Board member of MLH Holdings, LLC a
parent entity of MLH Explorations, LLC) Jeff Cook Chief Financial Officer, Pepsi and National
Brand Beverages, Ltd. Principal (Board member of MLH Holdings, LLC a parent entity of MLH Explorations, LLC)
David Clapper Principal, Mainline Investment Partners Chief Executive Officer (CEO), Principal, Financial Backer, Operator
Albert Parker Attorney General Counsel & Chief Compliance Officer (CCO), Principal, Operator
Christopher Witowski Senior Director, Research and Development Chief Scientific Officer (CSO), Principal, Operator
Robert Gorovitz Accountant Financial Backer, Principal (Board member of MLH Holdings, LLC a parent entity of MLH Explorations, LLC)
Richard Michael Smullen Management Chief Commercial Officer, Operator, Principal
Ramon Rivera Finance Chief Financial Officer (CFO), Operator, Principal
Peri Higgins President of Evolve Advisors, Management Consultant
Chief Administrative Officer (CAO) and Human Resources Director, Principal, Operator
Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 20 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR09 Green Health PA, LLC Drexel University College
of Medicine Jamie Snider 610.662.3846 [email protected]
Source: Clinical Registrant application section 1 & 2
Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR09-D19-2101 Green Health PA, LLC Northeast Limited Liability Company PO Box 25088 Philadelphia PA 19147 610.662.3846 610.645.5324 [email protected]
Source: Dispensary application section 1 & 18
Dispensary Facility Information* Primary Name Primary County Second Name Second County Green Health PA Scranton Dispensary
Lackawanna Green Health PA Glen Mills Dispensary
Delaware
Source: Dispensary application section 2
Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Lindy Lou Snider Business Executive President and CEO
Jamie Scott Snider Business Executive CFO and Vice President
Kristie Bunty Zises Business Executive
Corey A Burchman Physician Chief Medical Officer
Engdawork Admasu Engda Scientist Chief Science Officer
Cory J Remp Security Consultant Chief Security Officer Source: Dispensary application section 20
* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Clinical Registrant Phase II Applicant Information
PA DOH Page 21 of 23 June 19, 2019
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR09-GP19-1105 Green Health PA, LLC Southeast Limited Liability
Company PO Box 25088 Philadelphia PA 19147 610.662.3846 610.645.5324 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality Green Health PA South Heidelberg Grower-Processor
2 Corporate Boulevard Sinking Spring 19608
Berks South Heidelberg Township
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Lindy Lou Snider Business Executive President and CEO
Jamie Scott Snider Business Executive CFO and Vice President
Kristie Bunty Zises Business Executive
Corey A Burchman Physician Chief Medical Officer
Engdawork Admasu Engda Scientist Chief Science Officer
Cory J Remp Security Consultant Chief Security Officer Source: Grower/Processor application section 25
Clinical Registrant Phase II Applicant Information
PA DOH Page 22 of 23 June 19, 2019
Clinical Registrant Information ID Number Name Purported ACRC Name Primary Contact Name Primary Contact Phone Primary Contact Email CR10 Curaleaf PA, LLC Perelman School of Medicine at
the University of Pennsylvania Joseph F. Lusardi (781) 451-0150 [email protected]
Source: Clinical Registrant application section 1 & 2
Dispensary Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR10-D19-1505 Curaleaf PA, LLC Southeast Limited Liability
Company 301 Edgewater Place Suite 405 Wakefield MA 01880 781-451-0150 [email protected]
Source: Dispensary application section 1 & 18
Dispensary Facility Information* Primary Name Primary County Second Name Second County Third Name Third County Curaleaf PA, LLC Philadelphia Curaleaf PA, LLC Montgomery Curaleaf PA, LLC Dauphin
Source: Dispensary application section 2
Dispensary Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Joseph F Lusardi Sole Manager, Curaleaf PA, LLC and President and CEO, Curaleaf, Inc. Operator, Sole Manager, Curaleaf PA, LLC
Justin Somers Curaleaf PA, LLC President Operator, Curaleaf PA, LLC President Source: Dispensary application section 20
* Clinical Registrant applicants could apply for up to six Dispensary facility locations; no Clinical Registrant applicant included more than five locations in their application.
Clinical Registrant Phase II Applicant Information
PA DOH Page 23 of 23 June 19, 2019
Grower/Processor Business Information ID Number Name Region Org Type Address City State Zip Code Phone Fax Email CR10-GP19-1506 Curaleaf PA, LLC Southeast Limited Liability
Company 301 Edgewater Place Suite 405
Wakefield MA 01880 781-451-0150 [email protected]
Source: Grower/Processor application section 1 & 23
Grower/Processor Facility Information Name Address City Zip Code County Municipality Curaleaf PA, LLC 305 East Church Road King of
Prussia 19406
Montgomery Upper Merion Township
Source: Grower/Processor application section 2
Grower/Processor Current Officer(s) First Name Middle Name Last Name Suffix Occupation Title in Applicant’s business Joseph F Lusardi Sole Manager, Curaleaf PA, LLC and President and CEO, Curaleaf, Inc. Operator, Sole Manager, Curaleaf PA, LLC
Justin Somers Curaleaf PA, LLC President Operator, Curaleaf PA, LLC President Source: Grower/Processor application section 25
