georgia composite medical board · 79777 alexander, danika lauren md 79778 aligeti, sabitha md...

Georgia Composite Medical Board

Minutes of the March 1 2018 Meeting

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The Georgia Composite Medical Board (GCMB) held its regular meeting on March 1, 2018 at

2 Peachtree St. NW, Atlanta, Georgia, to consider Medical Board matters.

Board members present:

E. Daniel DeLoach, MD, Chair

J. Jeffrey Marshall, MD, Vice Chair

John S. Antalis, MD

Keisha Callins, MD, MPH

Gretchen Collins, MD

John Downey, DO

Charmain Faucher, PA (ex-officio)

Alexander S. Gross, MD

Thomas Harbin, MD

Rob Law, CFA, Consumer Member

B. K. Mohan, MD

David Retterbush, MD

Joe Sam Robinson, MD

Barby Simmons, DO

Ronnie Wallace, Consumer Member

Management and legal staff present:

LaSharn Hughes, MBA, Executive Director

William Butler, MD, Medical Director

Max Changus, , Senior Assistant Attorney General

Carl Bedingfield, MD, Assistant Medical Director

Tara Burks, Business Analyst III

Karl Reimers, Director of Investigation

Patricia Sherman, Enforcement Manager

David Stubins, Senior Assistant Attorney General

Phyllis White, Director of Special Projects

Doris Williams-McNeely, Senior Assistant Attorney General

Joanna Zackery, Licensure Manager

Board members absent:

Richard Weil, MD

CALL TO ORDER

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

AGENDA AND MINUTES

Dr. Retterbush submitted a motion, seconded by Dr. Marshall, to approve the agenda of the

March 1, 2018 meeting. The motion carried unanimously.

Dr. Retterbush submitted a motion, seconded by Dr. Antalis, to approve the minutes of the

February 1-2, 2018, meeting. The motion carried unanimously.

CHAIR’S REPORT

Dr. DeLoach discussed the following items with the Board:

The Board reviewed Dr. Downey’s Opioid worksheet guidelines.

Dr. DeLoach appointed a committee to study strategic planning for the Board’s future.



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Ms. Hughes gave the Board updated formation regarding number of physicians registered with a

DEA and the Prescription Drug Monitoring Program (PDMP). So far 19,530 have registered.

Donald Palmisano, Jr., Executive Director, MAG – discussed a bill that would address Sexual

misconduct issues. Donald Palmisano, Jr., responded with MAG,s efforts to notify their

members.

INTERIM EXECUTIVE DIRECTOR’S REPORT

Ms. Hughes, Interim Executive Director presented the report.

Ms. Hughes updated the Board with bills before the legislature.

1. Stacy Morgan, MD requested Board eligible be removed from his profile. Board

approved the request. to remove.

2. Jeff Lane asked is it legal for a doctor to post signage regarding a request for patients to

leave firearms in their car?

3. Question forwarded from the Georgia Board of Pharmacy regarding classification and

concerns of pre-filled saline flush syringes for use as part of the PIVO procedure.

4. Board reviewed Compressive Review Concerning Prescription Opioid Abuse in Chronic

Pain: An updated review of Opiod Abuse Predictors and Strategies to Curb Opiod Abuse:

Part 1. For information only.

5. Karen Conley can a lab in Florida process a test sent from a Georgia physician. Physician

would have to have a Georgia license.

Dr. Gross motioned to go into closed session. Dr. Marshall seconded the motion and it carried

unanimously. Dr. DeLoach recused.

Dr. Marshall declared open session.

APPEARANCE BEFORE THE BOARD

Dr. Gene Davidson requested an appearance before the Board. Dr. Davidson gave a history of

his background and medical history. The Board members asked questions concerning his current

and future plans. Dr. Davidson responded. Dr. Antalis and Mr.Wallace recused.

Dr. Retterbush motioned to go into closed session. Dr. Marshall seconded the motion and it

carried unanimously.



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Dr. Deloach declared open session.

Dr. Gross motioned to up hold the Board’s previous decision to deny the application. Dr.

Marshall seconded the motion and it carried unanimously.

RECESS

Dr. DeLoach declared the meeting in recess for the purpose of holding committee meetings.

RECONVENE

Dr. DeLoach reconvened the meeting at 1:30 p.m.

LICENSURE COMMITTEE

Dr. Retterbush presented the Licensure Committee report as a motion. The Board accepted the

amended report by unanimous vote.

The Board took the following actions:

Petitions to Waive Rules:

Petitioner Rule

1. Hoffman, Dustin 360-2-.02 Approved

2. Whitaker, April 360-2-.02 (5) Approved

3. Schwarz, Stephen 360-2-.01(c) Denied

4. Tuttle, Jessica 360-2-.07 (3) Approved

Other business:

1. Coronado, Esmerelda - ECFMG Certification - Does not meet requirements - re required

examinations approved.

2. Attaran, Saina - AGGME program – Will submit Petition to waive rule

3. Gyambibi, Kakra - Accept request to withdraw application.

4. G.W. – Deny

5. R.R – Invite for interview.

6. SS – Invite for interview.

7. MD (Reinstatement application) – Invite for interview.

8. WT - (Reinstatement application) – Invite for interview.

9. TV – Invite for interview

10. Rop, Baiywo – Table

11. Bowles, Theodore – Table

12. Campbell, Ellen – Table

13. Rao, Ramakirshna – Table

14. Rothenberg, Richard – Table

15. TS – Allowed to withdraw application.

Approved Applications for Licensure:

LIC_NBR NAME Designation



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79774 BURNS, VALERIE CELESTE MD

79775 KALLI, SIRISHMA MD

79776 MALAY, JOSH MD

79777 ALEXANDER, DANIKA LAUREN MD

79778 ALIGETI, SABITHA MD

79779 AQUI, ERNEST ALVIN MD

79780 BARBIER, GREGORY EDWARD MD

79781 BRITTAIN, ERIC MD

79782 CLEARY, RYAN KIM MD

79783 CLARK, ELIZABETH ANNE MD

79784 GOHIL, AJAY D MD

79785 STANTON, RYAN ASHLEY MD

79785 STANTON, RYAN ASHLEY MD

79787 BROWN, JUSTIN BRADFORD MD

79788 BHAT, VIJAY RAJENDRA MD

79789 BLAIR, JORDANA SARAH DO

79790 CARROTHERS, IRENE ATAMAH MD

79791 CLERY, MICHAEL JOHN MD

79792 DAVE, HEMAN MD

79793 DEMARAIS, DEBORAH ANNE MD

79794 SUNDY, RAEL DAVID MD

79795 TAYLOR, BRANDON JAMES MD

79796 WILSON, ANDREW ARMOUR MD

79797 STICKLER, MICHAEL A MD

79798 SANCHEZ-SILVA, MARTHA PATRICIA MD

79799 KAPUR, SEEMA MD

79800 JOHNSON, STEPHANIE MARGARET MD

79801 ADERANTI, MOSES A MD

79802 STEWART, ADRIANA TURTESSA DO

79803 WOODS, GARY MD

79804 SHAH, DISHANT GIRISH MD

79805 HANNA, JOHN MD

79806 ABOUDARA, MATTHEW MD

79807 AMIN, VAIBHAV MD

79808 AHMED, AFTAB MD

79809 BONDER, ADAM MD

79810 AGARWAL, SAMIR MD

79811 WONG, PHILIP MD

79812 WESTON, MICHAEL ANDREW MD

79813 SHIH, GARY WEIFENG MD

79814 GUILLOT, LORI MICHELE MD

79815 BAXTER, MARGARET MD

79816 CARTNER, AGNES MURCHISON MD

79817 AHUJA, MONICA MD

79818 ARNOLD, SONYA ARNOLD MD



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79819 BEESLEY, STEVEN DANIEL MD

79820 BELKNAP, SAMUEL WEBSTER MD

79821 BERRY, DUNCAN MD

79822 BOBROVNIKOV, VLADIM MD

79823 MARSHALL, JOHN BENJAMIN MD

79824 BRANSON, CHANTALE MD

79825 DOMINGO, LIEZL TERSOL MD

79826 ALI, MUHAMMAD MUSTAFA MD

79827 ALO, KENNETH MARK MD

79828 LATIF, SARAH MD

79829 DO, JENNIFER STRATTON MD

79830 GERBER, MARK BENJAMIN MD

79831 IBANEZ, DELFIN G MD

79832 MAYO, SHAWNETTE MIREILLE MD

79833 NARASIMHAN DIXIT, ADVITEEYA MD

79834 MODLIN, DAVID MORGAN MD

79835 ORILLOSA, SUSAN MD

79836 OSMOND, JOHN D MD

79837 PETE, KARL LYNDELL MD

79838 BEST ROCHA, ALEJANDRO MD

79839 LEI, PENG MD

79840 MANDAWAT, ANANT MD

79841 MONTASER, AHMED ABDELHADY AHMED IBRAHIM MD

79842 SAYEED, JAWEED MD

79843 SULLIVAN, EDWARD ALLEN III MD

79844 WITTE, NATALIE ANN MD

79845 ZHENG, KAREN SIJIE MD

79847 FREEMAN, BRIAN MICHAEL MD

79848 KLASSEN, CHRISTOPHER MD

79849 OJO, OLUWATOSIN MD

79850 PITIYANUVATH, NATARIA MD

79851 MICKELSON, LEAH DO

79852 JORDAN, MARK SAUNDERS MD

79853 GONZALEZ, MAURA ELAINE MD

79854 HENDRIX, JOSHUA MD

79855 HAYES, EARLE WENDELL MD

79856 GABRIEL, JOHN MR MD

79857 HARRUNA, SHAYIBY MD

79858 NUGENT, GRACE COLLETTE MD

79859 ASWATH, GANESH SHREEHARI MD

79860 PRABHAKAR, PRANAY MD

79861 BOSHELL, BILL HUNTER MD

79862 CAMPBELL, PORSCHA D MD

79863 CHANG, JAMES WOOJONG DO

79864 ASH-BERNAL, RACHEL MD



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79865 HENDRIX, KRISTEN RENATA MD

79866 JAROSZ, TODD STEPHEN MD

79867 FISHER, STEPHEN MICHAEL MD

79868 ANAND, ANJOLI MD

79869 AUGUSTINE, NIDA RAUF DO

79870 BLACK, WHITNEY KAYLAN MD

79871 DAO, KIMBERLY MD

79872 DAWSON, VIRGINIA ROSE MD

79873 DOLBER, TRYGVE MD

79874 DREW, ALEXANDER MATTHEW DO

79875 FLYER, MARK MD

79876 CONKLIN, JOSEPH EARL JR MD

79877 JACKSON, GREGORY DWAIN MD

79878 GEGG, CHRISTOPHER ANTHONY MD

79879 PATEL, VATSAL MD

79880 PRYOR, KIMBERLEY DO

79881 SOERRIES, SCOTT MD

79882 TAMIRISA, KIRAN CHARY MD

79883 TANKO, QUENTIN MD

79884 THOMAS, ROBERT HENRY MD

79885 WHITAKER, APRIL MD

79886 YADAV, HEMANG MD

79887 ABDUL-HADI, OMAR MD

79888 BISHARAT, MOHANNAD MD

79889 DRUMMOND, HARRY MD

79890 DUCLOS, MARTIN ARTHUR MD

79891 BENS, SEBASTIAAN DO

79892 CARROLL, WILLIAM MD

79893 BAUTISTA, JOHN THEODORE MD

79894 NECKMAN, DAVID WADE MD

79895 PETERSON, JUSTIN WAYNE MD

79896 MARSCH, JEFFERY TROY MD

79897 NAYAK, VJAY MD

79898 MARBAS, LAURIE LADAWN MD

79899 MIRZA, IMRAN MD

79900 MITCHELL, JULIE DO

79901 LEWIS, CHANTAL MD

79902 KHALD, MUHAMMAD AZAM MD

79903 STERN, JOEL BENJAMIN MD

79904 SMITH, BLAKE ROBERT MD

79905 SMITH, CHRISTOPHER BLAKE MD

79906 STOUDENMIRE, CHARLES JACOB MD

79907 RICHARDSON, NICHOLAS SCOTT MD

79908 RAJENDRA, ANIL MD



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79909 SAKR, MARK MD

79910 SAMALA, MALLIKARJUN MD

79911 SINCLAIR, ELIZABETH MIRIAM MD

79912 WHITE, STEPHEN MD

79913 WILSON, TRENTON MD

79914 TENG, STEPHANIE MD

79915 TRAN-NGUYEN, JACKLYN MD

79916 TRACY, BRETT MITCHELL MD

79917 JENNINGS, SARAH FOPPE MD

79918 KHALID, HEENA MD

79919 FINDEISS, LAURA MD

75720 HOFFMAN, DUSTIN CARL MD

79971 PATEL, SHIRISHKUMAR NARSINHBHAI MD

79972 POU, JASON DAVID MD

79973 RONEY, WESLEY BRIAN MD

79974 TAMIRISA, MITHILESH KUMARI MD

80021 MATA, MARIA MD

Reinstatements Approved:

11372 HITCH, WILLIAM STROUD MD

17011 SILVER, JEROME IRA MD

21741 MIKELL, JULIA LECRAW MD

24774 ALVARADO, CARLOS S MD

34760 ADAMS, JOHN BARNARD MD

38811 JACOBSON, WENDY NAN MD

38830 EPPELBAUM, LAWRENCE EDWARD MD

40952 MAJEED, KAZI IMRAN MD

45681 DURDEN, MARK DANIEL IV MD

46795 NUTT, RICHARD LEVERNE MD

48040 DOENLEN, HENRY ALEXANDER II MD

49728 DEPIPPO, PAUL ALEXANDER MD

49832 SIX, RICHARD R MD

54468 BULLINGTON, ANDREW BRANDON MD

57437 GOODWIN, ANIKA SARAN MD

58613 KIM, JIN DAE MD

62364 JACOBSON, MARTIN ALLEN MD

63458 MEEKINS MOORE, DIAHANN MARIE MD

64669 LIVIERATOS, SPEROS G MD

65137 LUFADEJU, ADETOYE MD

65148 MOTA-CASTILLO, MANUEL RAMON MD

67016 FOWLER, LINDSAY ELIZABETH DO

68241 MANDALAPU, KAMAL KISHORE MD

72054 LIIPFERT, RICHARD BURTON MD

73198 BADEL, SERGIO MD



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73745 DANIEL, DEEPU DO

Dr. Gross motioned to go into closed session to discuss investigative matters. Dr. Robertson

seconded the motion and it carried unanimously

Dr. Deloach declared the meeting in open session.

NURSE PROTOCOL COMMITTEE

Dr. Callins presented the Nurse Protocol Committee report as a motion. The Board accepted the

report by unanimous vote.


Approved the following protocols under the provision of O.C.C.A. 43-34-25.

APRN Last APRN First Middle Supervising Physician Name

Acero-Smith Grace Elena Ralph Parks Warnock, MD

Adams Lauren James Sinclair, MD

Ali Natalie Joel Carpenter, MD

Andrews Mary Frances Jeffrey Sarata, DO

Archer Orchid Jocelyn Bayliss k. MD

Bachtel Mary Kathleen J Sharon Rasinovitz, MD

Baker Carol Dean Davidson Richard L. Elliott, MD

Battle Shomika Lasha Rodolfo B. Carrillo, MD

Beckles Saphia Reemon Bishara, MD

Belcher Robin Eric Lehman, DO

Belocura Edgardo Pableo Moyosore Suleiman, MD

Blanden Shekella Demetrice Robert David Campbell, MD

Boatright Howard Amber Brooke Shannon Ellis, DO

Boswell Tammi Joleen Dako, MD

Bowden Carrie Anne Jimmy D.Pruitt, MD.

Brainard Melanie Lynn Andrew Tucker, MD

Brinkley Valena Denise Michael Rogers, MD

Brown Rebecca Angeles Denise Thompson Cary Rose, MD

Brown Allyson Deanne Travis Jasper, MD

Brown Eric Jay Michael Ross, MD

Buchanan Kristie L. Sumandeep S. Sangha, MD

Burke Amber T. Josh Simmons, MD

Byrd DeAudrey Stokes Michelle Y. Evans, MD

Calabro-Payne Antonia Lyn Richard Tanner, DO

Cantrell Jennifer Suzanne Charlotte Williams Khan, MD

Carey James Azif Safarulla, MD

Cayado Michele A Ravindraprasad Shekarappa, MD



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Cesar Chantal Robert K. Bond, MD

Chaney Dianna Nicole Charles Francois Cowart, MD

Chase Lana Marie Dominic E. Nkwocha, MD

Childers Shelly Stewart Amy K. Pearson, MD

Christina Merryman Michael B. Hocker, MD

Churbock Provins Cathleen Ann Melissa H. White, MD

Clark Robin Ann John J. White, MD

Cochran Christen Diane Sam Khair, MD

Conley Marla Cheryl Perkins, MD

Cooper N'Kema Jernee Ralph P. Warnock, MD

Corley Caitlin Michele Subhadra Shashidharan, MD

Cousin Carisalyn Nicole James M. Williams, MD

Cranston Catherine William Powell Jr. MD

Crawford Angela Nicole Ralph P. Warnnock, MD

Deguia Susan E. Ognjenka G. Vukotic-Brkic, MD

Denny-Smith Tammy Jane Srinivas Kolipaka, MD

Dixon Krystle Patricia F. Patterson, MD

Donaldson Yvonne Patrick Norvilus, MD

Doneski Christopher Steven C. Perlaky, MD

Downey Gloria Christoher Sarita Sharma, MD

Endsley Lynelle Bertram Prosser, MD

Estes Rachel Gatlin Muthusamy Sekar, MD

Etienne Josette Darrell Murray, MD

Ferrell Courtney Megan Staton Mark McKenna, MD

Forehand Brett Allen Kala K. Cunard, MD

Franklin Lori Anne Durwood Neal, MD

Furro Susan Ruth Montaivo, MD

Glaser Judy K. Joseph McEvoy, MD

Goniea Ashley Nicole Carlton Lancaster, MD

Green Amanda Joy Bharatkumar C. Patel, MD

Greene Priscilla Rowan Vincent G.Valencia, MD

Gregory Sarah Syed Agha, MD

Halder Michael Jeremy Nelson, MD

Hamilton Doreen Robert Collier, MD

Hand Kristi Allison Lauber, MD

Hand Kristi Lashun Allison Lauber, MD

Hanson Alexandra Tood Deavens, MD

Harvill Starr Dolapo Babalola, MD

Herron Lesia Divya Narayanaswamy, MD

Hill Erin Askew Charles Cowart, MD

Hogan Kara Krista J. Childress, MD



10

Hogan Kara Krista Jo Childress, MD

Howell Vanessa Raymond Easley, DO

Hughson-Chitolie Charisse Farhana Kaderin, MD

Hyers Heather Williams Michael A. Clark, MD

Iler Maria Sidhant Nagrani, MD

Jackson Harold Eugene Kimberly Harbin, MD

Jackson Savannah Bryanna Lindsey B. Roenigk, MD

Jackson Morgan Charlotte James Hunter Monroe, MD

Jasper Sherria Trenice Mazen A. Abdalla, MD

Jean-Louis Dora Demir Baykal, MD

Johnson Tamika Tamara Katherina Ekeji, MD

Jolly Tammy Michelle Madelaine Santo Vega, MD

Jones Dustin T. Richard J. Dowling, MD

Jones Rhonda Dee Toni Sylvester, MD

Jones Stephanie Hal Motlow Herd, MD

Jones Tracy Michelle Michael Unger, MD

Jordan Keri Cheryl Perkins, MD

Kandler Genevieve Matthew Whitley, MD

Kaniewski Cortney Morgan Ramanpreet Dhindsa, MD

Karr Nance Carol Nancy Q. LeFever, MD

Keen Ashley Paige Frank D. Jones, MD

King Tia Denae Lester A. Freeman, MD

Kinnett Marsha James Drury, MD

LaBella Virginia Calhoun Jerry Williams, MD

Lampkin Anndrea M. Chidinma D. Kabba, MD

Liang Katherine Michael E. Brown, MD

Liddell Jacquiece Kristi Kinsey Gotier, MD

Loepker Sarah Nicole Ali Araghi, MD

Long Ashley Maged Abdeimalik, MD

Manga Ebot Bi Virginia Joy Wight, MD

Mansfield Crystal A. Altee Johnson S.MD

Marcius Marva Monroe David M.Alvarez, MD

Marcius Marva Monroe Amr Agha, MD

McAdams Mary Kate William James Conkright, MD

McCormic Cory Lee Pankaj Agrawal, MD

McCriskin Samantha Dawn Robert Harris, MD

McIntyre Marcia Elesea Michael Metry, MD

Mendoza-Rodriguez Erika Sherri Barton, MD

Merritt Marcie LeAnn David L Day, DO

Midler Hillary Leah Lowman, MD

Miller Ashley Delene Roy C.Brownlow , MD



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Mitchell Roberta Stephen Anthony Messner, MD

Mobbs Mary Charlotte Khan, MD

Moore Martha M. Malini K. Reddy, MD

Morris Octavia Tommy Morgan, MD

NcNulty Amanda Rebecca Philip O'Connell, MD

Nelson Tricia Ezad Ahmad, MD

Newberry Brittany Jimmy Daniel Pruitt, MD

Norton Kathryn W. Modele O. Ogunniyi, MD

Norton Carol B. Valencia Burrus, MD

Nozile Petra Mitzi Rubin, MD

Ohanaja Pristella Ogechi Gloria Richards, MD

Pardue Paige Thomas Morianity, DO

Paris Kimberly Dawn James Graham, MD

Parker Dawn Michelle Ledford Gulshan Harjee, MD

Pearson Wendy C. Robert S.Cowles , MD

Pearson Jessica Michelle Timothy N. Udoji, MD

Peeples Corey D. Mark F.Corey, MD

Phelphs Ashley Lynn William Keeting, MD

Phillips Rachel Kate Karan Julka, MD

Powell Cynthia Leigh Marlene Zetzer Shivers, MD

Prather Kaley M. Bryan L. Woods, MD

Primas Brittanny Tanya Jones, MD

Puvis Debbie Lydia Tanner, MD

Radovich Haley Elizabeth Hatem Asad, MD

Randall Marjay Gladys Lawrence Reccoppa, MD

Ray Jacqueline M. Jeffrey Sarata, MD

Reed Melinda P. Tamara E.Sealy, MD

Reed Tracy Arnett Ziad Ahmad Ahmadie, MD

Reisen Amy Charlotte Grayson, MD

Richards Catherine Crenshaw John William Thornton III, MD

Rose Karen Alana Williams, MD

Rose Karen R Matin Abdul, MD

Salley Audrey E. Robert S. Cowles, MD

Samples Lisa Ashley Nicole Davidson, MD

Sanders Diana David P Fieseler, MD

Seabrooks Sharika Shenika Steven Lee Morganstern, MD

Seitz Roslyn Marie Matthew Taylor Keadey, MD

Sherman Carmen Judy Rita Deattrea Beckford, MD

Sikes Devan Sandra Gibbs, MD

Simokaitis Sabrina Ferrol A. Sams III, MD.

Skinner Robbie Leah Himanshu Mukesh Patel, MD



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Skipper Dalton James James Rogan, MD

Soto Gina William Benedict, MD

Sparks Lakeisha Ian Davis, DO

Stallings Judith A. Hans Lee, MD

Stephanopoulos Irene Glenis Craig Heigerick, DO

Stephens Tammy Lenora Allen, MD

Steves Amy B. Kara Prickett, MD

Stewart Deborah Margaret David Samuels, DO

Stoyle Sheryl Angel Arthur Yancy ll , MD

Stoyle Sheryl A. Eric M. Lehman, MD

Taylor Sebrina Guy Y. Augustin, MD

Thomas Cassandra Crystal Owens, MD

Thompson Taylor Victoria Roshan George, MD

Tran Tammy Tu Zavier C. Ash, MD

Trivedi Tran B Vera Reaves, MD

Ulbricht Lisa Price Nathan Michael Polite, MD

Van Ness Kimberly Megan Deborah Bates, MD

Wade Nathan Charles Craig Byron Colby, MD

Webb Erica Williams Nailah Abdulbaagee, MD

Welford Colleen A. Robert F.Dollinger, MD

White Dianna Lynn Melissa D. Primrose, MD

Wilder Janice M Dawn Wilson, MD

Williams Tammie A. Bert P. Wall, MD

Williams Whitney N. John Fuller Mynatt Jr. MD

Willis Kristen Alexis Hicham Churbaji, MD

Wilson Catherine Marie Melissa Denise Primrose, MD

Wood Amy Lance Slade, MD

Wright Brooke Blackwell John Aicher, MD

Yoo Jiwon James Y. Lee, DO.

Young Caitlin Crowe Dolores Haviland-Foley, MD

Young Angelique Antony Labady, MD

Determined that the following protocol agreements meet the provisions of O.C.G.A. 43-34-25

with changes.

APRN Supervising Physician

1. Abt, Ashley Mark A. Lee, MD

2. Awwah, Diana Richard G. Spurlock, Jr., MD

3. Ayer, Adam Krista Childress, MD

4. Barker, Lauren Ron Alleyne, MD

5. Beckles, Saphia Reemon Bishara, MD

6. Bell, Katrina Padmashree Woodham, MD

7. Broussard, Jennifer Canady Sheryl, MD



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8. Burnham, Cynthia Roberts, Benjamin, MD

9. Dawner, Charmaine Alexander Osowa, MD

10. East, Angela Childress, Krista, MD

11. Genevieve, Kandler Mathew Whitley, MD

12. Harvey, Heather Navin Patel, MD

13. Hoffman, Judy Maybury, Alexander, MD

14. Hovan, Katelyn David Ecklund, MD

15. Iler, Marie Walker-Blake, Tameka, MD

16. Jones, Stephanie Herd, Hal, MD

17. Johnson, Ryan David Campbell, MD

18. Krawczyk, Whitney Levy, Jonathan, MD

19. Seitz, Roslyn Mattew Keadey, MD

20. Simmons, Nicole Brandi Warren, MD

21. Tesfaye, Woinshet Dolapo Babalola, MD

22. Primas, Brittany Tonya Jones, MD

23. Mitchell, Roberta Stephen Messner, MD

24. Norton, Carol Valencia Burrus, MD

Other Business:

1. Board discussed a request whether an APRN can remove in-grown toenails based on

experience and taining.

2. Board requested the staff to contact the South Carolina Board, to obtain information on

how they handle APRN practice and telemedicine.

PHYSICIAN ASSISTANT COMMITTEE

Dr. Antalis presented the Physician Assistant Committee report as a motion. The Board accepted

the report as amended by unanimous vote.


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

PA Supervising Physician

Adams, Emma Gee, John

Anderson, Katherine Payne, Diane

Birth, Synquincity Jones-Taylor, Cedrella

Bowers, Amanda Merritt, James

Brack, Chelsey Hoodbhoy, Nadeem

Brehob, Christina Chronos, Nicholas

Brown, Jamar Traub, Jeff

Dichiera, Robert Cook, Jay

Gaston, Anne Jones, John



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Gatlin, Lawson Chebuhar, Craig

Holl, Nicholas Lafosse, Vera

Hublikar, Swaraj Harrison, Jason

Hurst, Alexandra Daniels, Lisa

Kazinec, Joel Kayal, John

Louvin, Kelly Erinle, Akinwande

Momin, Anikraza Nelson, Jeremy

Murphy, Cassidy Alkhatib, Mhd Anas

O'Donnell, Jennifer Ashby, Talitha

Reichman, Daniel McMillen, James

Rodriguez, Alfred Gluzman, Alexander

Romeyn, Leslie Sayeed, Shariq

Rush, Yvonne Jones-Taylor, Cedrella

Schweikarth, Lindsay Rayappa, Steven

Taub, Sarah Wilkes, Joseph

Waters, Jessica Goel, Anuj

White, Sheena Sells, Deneta

Young, Brittany Szabo, Stephen

Approved the following applications for initial licensure without a supervising physician

PA

Alvarez-Forte, Igor

Bicher, Jordan

Edwards, Roxanne

Grammes, Lindsay

McKinnon, Meagan

McKown, Brian

Medved, Anne

Mustafa, Malaka

Pandya, Neerali

Pitts, Johnny

Poindexer, Katherine

Vargas-Vera, Sarai

Approved application for reinstatement with a supervising physician:


Bell, Rebecca Fareed, Ayman

Approved application for reinstatement without a supervising physician:

PA

Miechiels, Kimberly



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Approved the following application for reinstatement with a supervising physician pending

additional information:


Ward, Miranda Tobin, Joseph

Approved the following application for reinstatement with a supervising physician with a NON-

Disciplinary Private consent order and $500 fine for unlicensed practice:

PA

A.L.

Approved Add/Change applications:


Ali, Anisa Merchant, Riddhi

Anderson, Adrienne Watts, Ronald

Askew, Esther Heindel, N Hadley

Brooks, Haidy Barton, Sherri

Busch, Mitchell Baker, Donald

Cassidy-McKinney, Kerri Strother, Reginald

Chambers, Kelli Flandry, Frederick

Coderellis, Simone Johnson, James

Cottrell, Morgan Olliff, Stacy

Couey, Christopher Reddy, Ram

Cox, Allison Griffith, Timothy

Cox, Shannon Odjegba, Ochuko

D'Angelo, Maria Tafor, Stephen

Davis, Kelsey Hall, Heather

DeGraw, Katy Self, Thomas

Deviese, Rachael Johnson, Scott

Dexter, Kathy Vandemark, Wendy

Dinh, Elizabeth Boudreaux, Margaret

Dixon, Tamika Lynde, Grant

Duvall, Chelsea Lee, Charles

Edwards, Marshall Carrington, Helen

Edwards, Marshall Darji, Jaykrishna

Elswick, Emily Storey, Suzanne

Everidge, Angel Elkin, Gary

Fowler, Mandi Wieskopf, Bram

Fowler, Timothy Lee, Mark

Fowler, Timothy Brand, David

Freelen, Chris Siegelman, Jeffrey

Galon, Gabrielle Goss, Jennifer

Green, Sonya Grossman, Ilene

Harris, Blair Jain, Pravin



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Henderson, Brittney Burkmar, Jennifer

Hutchins, James Glick, Wesley

James, Alexandra Rendon-Garcia, Jose

Jenkins, Patrick Gallo, Dominic

Johnson, Cheri Singhal, Sunit

Johnson, Justin Nettey, Ronald

Jones, Stacia Tobin, Joseph

Khan, Reja Olliff, Stacy

Kimsey, Elicia Andrews, Amana

Klein, Susan Vandemark, Wendy

Lindsay, Renee Roberts, Donna

Luong, Phuong Bynum, Aliya

Lvovich, Vadim Narayan, Preeti

Mansoori, Anissa Taliaferro, Sumayah

Marcellino, Jennifer Findley, Ambrous

Martin, Tamara Munireddy, Sanjay

McGraw, James Federico, Thomas

Megay, Abigail Portzer, James

Mehta, Meena Helfman, Steven

Morrison, Linda Levy, Jason

Neill, John Hajo, Nawar

Nguyen, Khang Polk, Reynaldo

Nieves, Jessica Pandya, Rajiv

Nolen, Johnathon Morrison, Douglas

Noon, Alan Moody, Raymond

Ordonez-Fall, Katherine Cangiano, Jose

Owens, Erin Holladay, David

Pandya, Kalyani Brady, Colin

Pankowski, Laura Erens, Greg

Patton, Michael Morgan, Joe

Rama, Nisha Roth, Jeffrey

Reeves, Lasonja Vallabhaneni, Akhil

Reeves, Millie Alston, Mary

Rose, Kayla Rose, Cary

Rote, Rebecca Brosnahan, David

Sanders, Deanna Bowman, Robert

Schumacher, John Davtyan, Hakob

Sears, Shelley Lipscomb, Michael

Singh, Amanda El-Deiry, Mark

Smith, Carley Feliciano Aponte, Alexandra

Smith, Jawauna Rizvi, Syed

Snyder, Melody Burch, Jason

Stephens, Andrew Byrne, John



17

Stone, Dawn Gedrick, Brooke

Tolbert, Renarda Occhipinti, Marcus

Tran, Quynh Bechara, Rabih

Tsonas, Alana Jackson, Leopold

Turk, Kendyl Whisenhunt, Anumeha

Turner, Moniqua Greene-Harris, Sandea

Von Der Schulenburg, Amanda Hanafi, Magdi

Ward, Cody Coe, Stanley

Watkins, Angela Jacobs, William

Williams, Michelle Frinks, Terence

Williamson, Melissa Brosnahan, David

Willingham, Justin Thompson, Byron

Wilson, Jerry Cole, Tonya

Won, Chongmyong Talley, Roy

Zimmermann, Katherine Schwock, Kathy

Approved the following Additional Duties Request:

Mollie Heimerich PA-C—with Dr. Rita Mezzatesta

Peripheral Joint Injections (to Knee Only)

Ashley Fullerton PA-C—with Dr. Michael Bosley

Dialysis Catheter Insertion

Port Placement

Bone Marrow Biopsy

Intrathecal Injection

Annsley Matthews PA-C—with Dr. Jeffrey Silveira

Nasopharyngoscopy (Order, Perform, and Interpret)

Victoria Suttles PA-C—with Dr. Jeffrey Silveira

Nasopharyngoscopy (Order, Perform, and Interpret)

Lacey Wood PA-C—with Dr. Raven Elosiebo-Walker

Micro-Needling Rejuvapen

Ultherapy

Clayton Young PA-C—with Dr. Marcus Brown

Stress Testing Supervision

Informed applicant that this is not an Additional Duty:

Rebecca Bell PA-C—with Dr. Ayman Fareed

Full Psychiatric Evaluation Follow up



18

Invite for an Interview:

J.V.

Other Business:

1. Questions - What facilities in the state of Georgia are considered fee exempt? Board

replied On the Initial and Reinstatement Physician Assistant application, questions

seventeen (17) and eighteen (18) are to be updated as follows:

17. Are you an employee of the state of Georgia?

18. Are you an employee of a county government of the state of Georgia?

On the Physician Assistant application to add/change supervising physician,

questions fourteen (14) and fifteen (15) are to be updated as follows:

14. Are you an employee of the state of Georgia?

15. Are you an employee of a county government of the state of Georgia?

2. Ruth Whitaker: Does the physician have to co-sign all H&P and Discharge summaries

for a PA? Board replied no, refer to the GCMB Rules and Laws and to the hospital’s

bylaws and/or policies.

3. Judy Cooper: Inquiry of applying for licensure without references, because she has never

worked as a physician assistant. Board approved for Interim Executive Director to send a

letter.

4. Approved PA Advisory Committee request to update the Reference Form C/D, to change

question three (3) to the following: Date and duration, you worked as precepted with

candidate

RESPIRATORY CARE COMMITTEE Dr. Collins presented the Respiratory Care Committee report as a motion. The Board accepted

the report by unanimous vote.


.

Approved Reinstatement Applications:

Holton, Brittani- pending additional information

Pumphrey, Amy- pending additional information

Approved Reciprocity Applications:

Alexander, Raoul

Davis, Deadria

Funderburk, Kristina

Jackson, Kimoy



19

Mann, Misty

Polka, Chelsea- pending additional information

Schmitz, Brooke- pending additional information

Sewell, Shannon

Approved Temporary Permits:

Abebe, Agernash

Assefa, Aster

Awoniyi, Felicia

Bourava, Anastasia

Hardy, Anita

Holloway, Roshawnda

Johnson, Shawndra

Kebede, Hiwot

Middleton, Tanzineka

Okeke, Kosi

Park, Minhee

Ramsey, Saundra

Sahle, Zetseat

St. Jean, Christina

Shelangi, Serena

Approved Administrative Upgrades;

Adinaro, Margaret

Adzer, Mimido

Brock, Taylor

Dahal, Radha

Ellis, Victoria

Fadili, Maria

Jackson, Elliot

Johnson, Taylor

Lee, Samuel

Miller, Felisha

Overstreet, Larisha

Ramos, Natalie

Waters, LaDundra

Other Business:

1. Reviewed Rule 360-13-01 “Requirements for Board Certification” and referred to the

Rules Committee for posting.

ACUPUNCTURIST COMMITTEE

Dr. Downey presented the Acupuncturist Committee report to the Board as a motion. The Board

accepted the report by unanimous vote.



20


Approved Quarterly Report of Limited License:

Gina Michaels

Approved Application for Initial Licensing:

Kenneth Huynh - Tabled pending additional information

Sungtaek Kang

Other Business:

1. Eunha Cho: - Schedule interview for a position on the Acupuncture Committee.

2. Mark Schwartz: Georgia Association of Acupuncture and Asian Medicine

Augusta University attended the meeting by teleconference offering with information

Doctorate in Physical Therapy and Acupuncture

PERFUSION COMMITTEE

Dr. Retterbush presented the Perfusionist Committee report as amended. The Board accepted the

report by unanimous vote.


Approved Application for Initial Licensure:

Patrick Davis

PAIN MANAGEMENT CLINIC COMMITTEE

Dr. Downey presented the Pain Management Clinic Committee report as a motion. The motion

was seconded by Dr. Marshall. The Board accepted the report by unanimous vote.


Approved initial applications:

File # Pain Clinic Name

455 Interventional Pain and Wellness - LaGrange

456 Interventional Pain and Wellness - Americus

457 Back to Life Pain Center

Ratified administratively approved applications:

License # Pain Clinic Name

142, 147, Ancora Pain Recovery

Add Physician Assistant Kerri Cassidy-McKinney

371, 431 Ancora Pain Recovery



21

Add Practicing Physician William Hammonds

371 Ancora Pain Recovery

Delete Practicing Physician Van Malia

381 Ancora Pain Recovery

Add APRN Princess Clark

159 Commerce Pain Management

Add APRN Kareen Carty-Davy

149, 374, 437, 439 Hemlock Pain Center

Add practicing physician Jerry Spivey

149, 374, 437, 439 Hemlock Pain Center

Add physician assistant Maria D’Angelo

Delete APRN Dwayne Taylor

153 Pain Management & Wellness Centers of GA

Add practicing physician Belinda Millington, MD

225, 226, 227 Pain Management Specialists of Atlanta

Add practicing physician Dominic Seymour

Other Business:

1. Board requested the committee to review the 2008 Georgia Board’s Guidelines for the

use of Controlled Substance for the treatment of pain Policy, and bring it up to date,

given the current opioid environment. The committee had proposed adopting the 2017

FSMB opioid guidelines, they received positive feedback from Georgia pain groups in

favor of that proposal. However, recently the Board has been made aware that the FSMB

is considering modifying their guidelines. Therefore, the Board has chosen to table the

idea of adopting the FSMB guideline, until they see the revisions.

COSMETIC LASER PRACTITIONER COMMITTEE

Dr. Gross presented the Cosmetic Laser Practitioner Committee report as a motion. The Board

accepted the report by unanimous vote.


Approved Assistant Cosmetic Laser Licensure Applications:

Liliya Feldman

Emily Raville

Lauren Siso

Donna Stiles – pending additional information.



22

LaTesha Sylva

Blakley White

Approved Senior Cosmetic Laser Licensure Applications:

Kayla Hopkins

Mary Overby

Nancy Reddington

Other Business:

1. Approved for licensure with Non Disciplinary Consent Order.

A.G

A.M.

2. M.B. Tabled for additional information.

RULES COMMITTEE

Dr. Gross presented the Rules Committee report as a motion. The Board accepted the report by

unanimous vote.

Rule Posting

Motion Dr. DeLoach seconded Dr. Retterbush and motion carried to refer the following Rule to

the Office of the Attorney General for review before posting for comment:

1. Rule 360-13-.01 “Requirement for Board Certification”

2. Rule 360-3-.02 “Unprofessional Conduct. Defined.”

3. Rule 360-15-.01 “Requirement for Physicians.”

Board approved an additional question to the FAQs

4. Rule 360-3-.07 “Practice Through Electronic or Other Such Means.”

Tabled a decision on the Rule, and will review the proposed changes at the next meeting.

Dr. Retterbush motioned to go in closed session to discuss confidential enforcement and

investigative matters. Dr. Marshall seconded the motion and it carried unanimously.

Dr. DeLoach declared open session.

ATTORNEY GENERAL (AG) LEGAL ENFORCEMENT ACTION REPORT (LEAR)

Mr. Reimers presented the AG /LEAR report, .Dr. Marshall submitted a motion, seconded by

Dr. Marshall to accept the report. The motion carried unanimously.

1. 20160273: Release files

2. Christian Kaufman MD: Accept Inactive Status



23

3. 20170406: Deny request

4. Harvey Leslie, MD: Deny request

5. Weston Welker, MD: Accept Inactive Status

6. 20170422: Table

7. 20151311: Close

8. Soren Thomas, MD: Table

9. Mark Durden, MD: Accept the Public Consent Order for licensure

10. Lawrence Eppelbaum, MD: Accept Public Consent Agreement for Reinstatement

11. 20150699: Approved terms of Public Consent Order

12. Peter Ulbrich, MD: OSAH decision for Suspension

13. Brandon Hicks, MD: Accept Public Consent Order for Indefinite Suspension

14. 20150931: Close

15. 20181415: Referred to AG-Summary Suspension

WELLNESS COMMITTEE

Dr. Collins presented the Wellness Committee report. The Board accepted the report by

unanimous vote.


1.

2. PHP report by Dr. Paul Earley and Robin McCown.

3. 20161818 - Granted approval to return to practice.

4. 20161327 – Order

5. 20070278 – Table

6. CC – Table

7. SF – Table

8. 20161410 – Table

9. 20160222– Grant extension

10. 20171579 – Approve doctor.

INVESTIGATIVE INTERVIEW REPORT

David Retterbush, M.D. presented the Investigative Interview report as a motion, and was

seconded by John Antalis, M.D. The Board accepted the report by unanimous vote. The Board

took the following actions.

20170116 Peer Review 20170157 Close

20170308 Forward to Investigations 20170434 Close with letter of Concern

20170447 Close 20170553 Close

20170969 Close 20172034 Close with Letter of Concern

20172212 Close 20172295 Close

20172351 Close with Letter of Concern 20172371 Close

20180070 Refer to AG for Notice of Hearing



24

INVESTIGATIVE COMMITTEE

The Investigative Committee report was presented as a motion by David Retterbush, M.D, and

was seconded by J. Jeffery Marshall, M.D. The Board accepted the report by unanimous vote.

The Board took the following actions.

Close:

20140113 20150575 20150576 20151201 20151318 20160111

20160853 20160884 20160911 20161057 20161102 20161769

20161775 20161911 20162263 20162293 20162401 20162471

20170278 20170328 20170475 20170505 20170838 20171289

20171438 20171517 20171615 20171642 20171643 20171754

20171762 20171794 20171832 20171895 20172100 20172155

20172166 20172170 20172290 20172333 20172348 20172349

20172350 20172381 20180003 20180040 20180079 20180084

20180085 20180089 20180096 20180120 20180127 20180148

20180156 20180222 20180267 20180275 20180301 20180304

20180383 20180384 20180386 20180388 20180403 20180426

20180442 20180460 20180461 20180488 20180489 20180510

20180511 20180525 20180538 20180540 20180544 20180545

20180551 20180564 20180594 20180595 20180597 20180599

20180602 20180614 20180617 20180623 20180631 20180632

20180634 20180637 20180644 20180645 20180646 20180651

20180657 20180659 20180667 20180673 20180684 20180687

20180696 20180697 20180699 20180703 20180709 20180712

20180718 20180726 20180732 20180737 20180739 20180763

20180768 20180776 20180781 20180798 20180799 20180820

20180882 20180913 20180961 20181040 20181050 20181174

20181192

Close with Letter of Concern:

20151145 20172005 20172136 20172139 20172152 20180159

20180164 20180260 20180437 20180622 20180738 20180753

20180835

Invite for Investigative Interview:

20162201 20162379 20170037 20171324 20171385 20171970

20172038 20180219 20180220 20180253 20180294 20180385

20180653

Further Investigation:

20160910 20161228 20170448 20180256 20180807



25

Table

20160648 20160665 20171581 20171790 20180001 20180479

20180678 20180679 20180686

Mirror Action from Other State:

20161672

Attorney General’s Office:

20151275 20162265 20170108 20170179 20170856 20181156

Peer Review:

20121568 20180189

EXECUTIVE SESSION

Dr. Marshall motioned to go into executive session. Dr. Antalis seconded the motion and it

carried unanimously to discuss personal actions.

Dr. Deloach declared open session.

There being no other business, Dr. Marshall submitted a motion, seconded by Dr. Antalis, to

adjourn the meeting. The motion carried unanimously. Dr. DeLoach adjourned the March 1,

2018 meeting at 6:30 PM

__________________________________ _____________________________________

E. Daniel DeLoach, MD LaSharn Hughes, MBA

Chairperson Interim Executive Director

__________________________

Recorded by Diane Atkinson

.

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