georgia composite medical board minutes of the january 9
TRANSCRIPT
Georgia Composite Medical Board
Minutes of the January 9, 2020 Meeting
1
The Georgia Composite Medical Board (GCMB) held its regular meeting on January 9, 2020, at
2 Peachtree Street, Atlanta, GA 30303, to consider Medical Board matters.
Board members present:
John S. Antalis, MD
Gretchen Collins, MD, Chair
Debi Dalton, MD
E. Dan DeLoach, MD
Alexander Gross, MD
Thomas Harbin, MD
Rob Law, CFA
J. Jeffery Marshall, MD
Matthew Norman, MD
David Retterbush, MD
Richard Weil, MD
Board members absent:
Charmaine Faucher, PA (ex-officio)
Andrew Reisman, MD
Barby Simmons, DO, Vice Chair
Management and legal staff present:
LaSharn Hughes, MBA, Executive Director
Lisa Norris, MPH, Deputy Executive Director
Phyllis Douglas, JD, Legal Services Officer
D. Williams-McNeely, Senior Assistant Attorney General
Max Changus, JD, Assistant Attorney General
Phyllis White, Executive Assistant
Latisha Bias, Enforcement Supervisor
Gina Haskins, Licensure Manager
CALL TO ORDER
Dr. Collins called the meeting of the Georgia Composite Medical Board to order at 7:30 a.m.
AGENDA
Dr. Weil submitted a motion, seconded by Dr. Antalis to approve the agenda of the
January 9, 2020 meeting. The motion carried unanimously.
MINUTES
Dr. Retterbush made a motion to approve the minutes of the December 5, 2019 meeting. Dr.
Marshall seconded the motion and it carried unanimously.
CHAIR’S REPORT
Dr. Collins made the following report:
1. Appointed Dr. Dalton Chair of RCP.
2. The Board has been invited to swearing in of new members today.
3. I will make Committee assignments for the new members today.
4. Reminder of off-site board meetings: PCOM June 4th and MCG, November 5-6.
Georgia Composite Medical Board
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EXECUTIVE DIRECTOR’S REPORT
Ms. Hughes made the following report:
1. Letter from Radha Bachman regarding Disposition of Medical Records. The family had
made every effort for the past year. Refer to the Attorney General’s Office.
2. FY – Article “Bid to loosen rules on mid-levels providers draws legislative debate.”
3. FYI – (FSMB) Proposed FSMB 2020-2025 Strategic Plan.
4. FYI – (FSMB) Senate Passes Gardner VA Accountability Legislation
5. FYI – Trinity School of Medicine Annual Report and update provided for next steps.
The Board to advise Dr. Skelton to submit the information to the National Committee on
Foreign Medical Education and Accreditation.
6. Email from John Groover regarding Board’s position on allowing a physician to execute
an arbitration clause relating to billing and/or medical care. Not within the Board’s scope.
RULES HEARING REPORT
Dr. Gross gave the following report.
Motion Dr. Weil seconded Dr. DeLoach to adopt the following rules:
Rule 360-3-.02(3) “Unprofessional Conduct”
Rule 360-3-.02(5) “Unprofessional Conduct”
Rule 360-3-.07 “Practice Through Electronic or Other Such Means”
CLOSED SESSION
Dr. Retterbush motioned seconded by Dr. Harbin to go into closed session to discuss
investigations and disciplinary matters, and it carried unanimously.
OPEN SESSION
Dr. Collins declared open session.
ATTORNEY GENERAL (AG)
Max Changus, Assistant Attorney General presented the Attorney General Status Report.
Dr. Antalis submitted a motion, seconded by Dr. Weil and motion carried to accept the report
and the following order:
Zackery Solomon, Interim Suspension Order.
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RECESS
Dr. Collins declared the meeting in recess for holding committee meetings and the swearing in
ceremony.
RECONVENE
Dr. Collins reconvened the meeting at 2:00 p.m.
PHYSICIAN LICENSURE COMMITTEE
Dr. Retterbush presented the Licensure Committee Report:
The Board took the following actions:
Applications Not Approved
JVR Allow to withdraw, or deny.
JH Clinical skills assessment, allow to withdraw or deny.
LS Clinical skills assessment, allow to withdraw or deny.
CM Allow to withdraw, or deny, or Administrative License.
MB Deny or allow to withdraw.
JS Interview.
FH Table for Petition to Waive Rule.
GI Table for additional information.
Applications Approved
Gao, Xing
Goad, Bradley
Lee, Emily
Harbolovic, Robert
Gira, Joseph
Pesante, Maisha
Elshazali, Gasim
Vassy, William
Rao, Nisha
Richards, Constance
(RNST)
Byrd, Lelan (RNST)
Williams, Robert RNST
Wilkinson, Arthur (RNST)
Synn, Jay
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Applications Administratively Approved
Name Degree
Abad, Zoilo MD
Adekola, Henry MD
Adeyemi, Adetoun MD
Al-Dabagh, Ahmad S MD
Anderson, Scott R MD
Auxier, Melinda M, DO DO
Baker, Bradley K MD
Baker, Sarah MD
Ball, Stephen K MD
Barnick, Sandra MD
Beasley, Stephen A MD
Benavides, Oscar J MD
Bograd, Benjamin A MD
Bolarinwa, Surajudeen A MD
Boudreau, Jamie M MD
Bui, Tu MD
Burton, Tracy C MD
Cham, Roxana MD
Chan, Angela W MD
Chang, Wesley MD
Crain, Jack L MD
Crawford-Harris, Paula MD
Daraei, Paul P MD
Davidoff, Ramin MD
Davis, Yonette MD
DeFrancesco, Martin A MD
Dorociak, Jeffery MD
Elshazali, Gasim M MD
Feltman Meals, Tiffany DO
Foster, Travis C MD
Gallegos, Juan MD
Gao, Xing Gazzara, Jeffrey A, DO DO
Gellert, Lan MD
Gelsomino, Michael J MD
Genau, Young J MD
Gira, Joseph MD
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Goad, Bradley J DO
Goddard, Allison L MD
Goldberg, Baruch R MD
Habib, Mena G MD
Hall, Lawrence MD
Hall, Leaton H, Jr. MD
Hamilton, Christina M MD
Han, Zeqiu MD
Harbolovic, Robert MD
Hardy, Martin K DO
Harrison, Andrew J DO
Hazbun, Tamara L MD
Heister, Robyn MD
Henry, De'smond M MD
Hill Taylor, Dreylana S MD
Hill, Jonathan F, Jr MD
Hofstra, Clayton T MD
Hurtig, Carl MD
Hurwitz, S. R MD
Ivey, Kristopher J MD
Jiang, Yunna MD
Jones, Danielle M MD
Jones, Erin A MD
Kahan, Michael E DO
Kallas, Omar N MD
Kang, Richard MD
Kazmi, Qasim A MD
Kimsey, Mallory MD
Langley, Rhet MD
Larsen, David T MD
Lee, Emily MD
Lee, Frank B MD
Lee, Jacqueline MD
Lee, Jaeyoung MD
Lerman, Mark N MD
Lewis, Darron R MD
Mackey, Kimberly A MD
Marcus, Charles V MD
Maron, Steven P MD
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McKenzie, James MD
Meyers, Clifford W MD
Mhatre, Pradnya MD
Milesko, Steven D DO
Miller, Royce C, Jr. MD
Minka, Sarah DO
Misner, Karissa DO
Mitchell, Timothy E DO
Mok, Charles MD
Montgomery, Martha MD
Morton, David C MD
Mostafa, Safinaz MD
Moursy, Yusra MD
Nasiru, Abdulrahman O MD
NAWATHE, AMITA D MD
Nwabueze, Onyemaechi MD
Offermann, Ellen G MD
Okpagu, Brittany U MD
Oladiran, Oyebola O MD
Oviedo, Rodolfo J MD
Parikh, Neil N MD
Patel, Rakesh M MD
Pathirana, Induruwa MD
Paul, Nicole M DO
Pedersen, Cort A MD
Perricone, Adam J MD
Persaud, Rajesh MD
Pesante, Maisha MD
Peterson, Jessica DO
Pridjian, Andrew MD
Qureshi, Mushtaq H MD
Rao, Nisha MD
Rivera-Gonzalez, Luis S MD
Rothman, Marc MD
Rugnath, Dinesh MD
Runnstrom, Martin C MD
Sahlgren, Leif B DO
Saldajeno, Virgilio G MD
Santa Maria, Jed A
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Sattar, Hamid MD
Schimmel, Matthew E MD
Shastri, Uma D MD
Sigler, Elizabeth C MD
Silverman, Krista DO
Simmons, Sarah MD
Singh, Vir MD
Slifer, Michael A MD
Stark, Stacy M DO
Stewart, Douglas R MD
Stokley, Cyrenah N DO
Syed, Peyton J MD
Synn, Jay MD
Talari, Sirisha MD
Thaker, Aakar MD
Thaker, Pratik H MD
Thames, Todd MD
Thomas, Richard D MD
Tiegs, Jacob I MD
Udoji, Esther N MD
Vargas, Gina M MD
Vassy, William M MD
VERMA, RAJIV MD
Vu, Anh-Thu MD
Wade, Jenna A MD
Wakim, Ryan MD
Walker, Leisa K DO
Walls, Endia N MD
Wendell, Richard P MD
Willis, Simon M MD
Winkler, Michael A MD
Wiseman, Jamie R MD
Woska, David J MD
Yasin, Nura MD
NURSE PROTOCOL ADVISORY COMMITTEE
Dr. Gross presented the Nurse Protocol Report:
Other Business
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1. ACNP and a Radiologist with a specialty of Radiology/Vascular & Interventional
Radiology. Is this considered a comparable specialty? Yes, (Procedure Related) must
have a FORM C for the training documentation.
Closed Session
Form C:
❖ Lumpkin, Ashley (Approved)
❖ Petrella, Cynthia - no documentation
❖ Tyus, Brittney (Approved)
❖ Warren, Felecia (Approved)
The Committee reviewed and approved the following protocols under the provision of
O.C.C.A. 43-34-25.
APRN DELEGATING PHYSICIAN
Agomessou, Ablavi Carla Bedford-Dixon, MD
Baker, Antwan Bruce Gioia, MD
Bartoli, Monika Francisco Echevarria-Santiago, MD
Bright, Retta Jeffrey Winston, MD
Carney, Julie (revisit) Ayman Fareed, MD
Carter, Kariba Shaila Day, MD
Corbin, Traci James Chappuis, MD
Cote, Wilma Odell Still, DO
Czarnecke, Heather Gurpreet Ahluwalia, MD
Desrosiers, Myrlene Saman Ghaffari, DO
Dover, Eileen Lynette Stewart, MD
Economy, Lee Matthew Keadey, MD
Green, Stephanie Robert Miller, MD
Holder, Maria Kelly McCants, MD
Kelley, Brandy Gurpreet Ahluwalia, MD
Miller, Jenifer Aaron, Alizadeh, MD
Moss-Traore, Gilda Susan Blank, MD
Ogun-Semore, Olawunmi Asaf Aleem, MD
Patel. Nishaben Paresh Thanki, MD
Pollard-Manigualt, Denise James Thomsen, MD
Rushing, Stephanie Francisco Echevarra-Santiago, MD
Salimonu, Janet Roberto Norniella, MD
Smith, Allison George Stickney, MD
Thomas, Maritess Julie Allen, MD
Unogo, Cindy Catherine Christie, MD
Yates, Brittany Julian McLendon, D
Zmaj, Andrea Lynette Wilson-Phillips, MD
The Committee determined that the following protocol agreements meet the provisions of
O.C.G.A. 43-34-25 with changes.
Bradley, Jennifer Okah Anyokwu, MD
Brooks, Rhonda (revisit) James Zubernis, DO
Forehand, Randall Jose Artadi, MD
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Fraiser, Lauren (revisit) Jaymal Patel, MD
Fuson, Lindsay Robert Prudent, MD
Garritson, Natasha Jose Artadi, MD
Glisson, Dawn (revisit) Jaymal Patel, MD
Hoefs, Jamie Rajasree Praturi, MD
Obuba, Joseph Edward Ajayl, MD Parkman, Sharade Paula Pollard-Thomas, MD
The Committee determined that the following protocol agreements do NOT meet the
provisions of O.C.G.A. 43-34-25. Lott, Jodi Jaymal Patal. MD
Madlock, Danielle Okah Anyokwu, MD
Nabritt, Terri Jose Artadi, MD
Nelson, Randall John Beaty, MD
Paulk, Carlas David Faulk, MD
Peterson, Gena Shroff, Manisha
Price, Catherine Jaymal Patel, MD
Smith, Daniel Jaymal Patel, MD
Snelling, Shakera Manisha Shroff, MD
Soles, Stanley Jaymal Patel, MD
Spivey, Villanueva John Beaty, MD
Stephens, Tammy Shahzad Hashmi, MD
Stidham, David Jaymal Paytel, MD
Protocols Approved
APRN Last APRN First Middle Delegating Physician Name
Adams Matthew Naser Humayun
Agomessou Ablavi Carla Bedford-Dixon
Aikens Malcolm John Lewis
Alferink Jessica Tonya Fordham
Allen Holly Edward Kang
Allen Krystal India Robinson
Ballard Monica Karla Booker
Banares Julie Zahidul Chowdhury
Barrett Kasie Sadiq Sohani
Bartoli Monika Francisco Echevarria-Santiago
Baumann Joni Henry Nygren
Beckett Davies Summer Christopher Edwards
Bell Maegan Najeeb Siddique
Branchetti Dana Premila Malhotra
Bright Retta Jeffrey Winston
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APRN Last APRN First Middle Delegating Physician Name
Brisibe Modupeola Janet Bivens
Brockman Hailey Rajan Kapoor
Brown Patrick David Pursalle
Brown Jessica Ibrahim Quinones
Bruner Christina Philip Kimsey
Buggs Temeka Jerry Phillips
Carney Julie Ayman Fareed
Carter Kariba Shaila Day
Carter Yaquisha Elwyn Clark
Chhun Domineque India Robinson
Chong Hannah Kyoung Lee
Christmas Marcy Vincent Culpepper
Cote Wilma Odell Still
Cox Stephanie Michael Scott
Cox Sheryl Ian Furtado
Czarnecke Heather Gurpreet Ahluwalia
Davis Audra Cesar Figueroa
Davis Sharonda Rajan Kapoor
Desrosiers Myrlene Saman Ghaffari
Dirven Tamara Ganesha Perera
Dover Eileen Lynette Stewart
Driggers Dawn Shad Stormant
Ellers Julie Allen Solomon
Emory Rebecca Sonam Bhalla
Faison-Oyebanji Yulanda Maged Abdelmalik
Farhy Heather Palanisamy Rajasekaran
Fernandez Lindsay Arthur McCain
Fletcher Jamez Divya Gupta
Fomunung Grace Dawit Weldemichael
Ford Latasha Jose Cangiano
Forman Anna Bryan Wells
Fuller Ashley Jill Dickerson
Gaddis Funlola Lawrence Powell
Gallivan Kathryn Charles Cha
Gangwisch Christine Angela Falany
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APRN Last APRN First Middle Delegating Physician Name
Gayden Andrea Judith Volcy
Georges Frantz Vera Tate
Gordon Sabina David Bryant
Green Stephanie Robert Miller
Griffith Megan Vinod Thourani
Haid Jeanne Derek Culnan
Hall Jocelyn William Burak
Harris Sarah Timothy Moore
Harrison William Sheila Best
Hart Rebecca Brad Goodman
Hawkins Chrystal Jennifer Francois
Heiges Alessandria Natalie Britt
Herrick Aleena John White Jr.
Hillmon-Scruggs Ebony Benjamin Bailon
Hodges Matthew Errol Graham
Holder Maria Kelly McCants
Holmes Taylor Giovanni Piovesana
Hood Marian Mitchell Wilson
Hosang Michelle James Namnoum
Hughes Leslie Teresa Bradford
Hunter Natalie Stephen Jarrard
Hurley Robin Michael Litrel
James Cindy Daren Wooten
Jolly Tammy Claudia Conde
Kelley Brandy Gurpreet Ahluwalia
Kelly Paul Izzeldin Abdalla, MD
Kemp Savannah Louellen Gurley
Kemp Savannah James McGowan
Kendrick Patricia Daniel Singleton
Knight Amber Richard Stevens
Kolovich Martina Gregory Kolovich
Kwee Mary Tam Nguyen
Leary Bridget Felix Sogade
Lee Knicole Jaxon Cox
Little Patrice Naima Cheema
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APRN Last APRN First Middle Delegating Physician Name
Lumpkin Ashley Sung Cho
Malcolm Alexis Henry Nygren
Malstrom Stacey Nydia Bladwell
Martinez Angelisse Sherri Barton
Merriman Laura Issac Sved
Miller Jenifer Aaron Alizadeh
Miller Marci Trushnaa Patel
Minter Mary Valarie Manley
Monroe Cecily Syed Rizvi
Mooyin Candice Alton Greene
Morgan Carley Richard Bowers
Moss-Traore Gilda Susan Blank
Neal Olivia George Powell
Nunnally Ashley Joseph Hobbs
Ogun-Semore Olawunmi Asaf Aleem
Olson Sheryl Wayne Chiu
Opare-Addo Margaret Margaret Schutte
Patel Nishaben Paresh Thanki
Paulk Tina Lauren Hudak
Phillips Shelly Henry Purvis
Pington Robin Chinedu Hwere
Pittman Amber Ian Furtado
Pollard-Manigualt Denise James Thomsen
Price Jennifer Abby Abisogun
Reed Meghan Jemy McLane
Rushing Stephanie Francisco Echevarria-Santiago
Saint-Amand Beverly Cindy Freed
Saint-Amand Beverly Kurt Jacobson
Salimonu Janet Roberto Norniella
Scarborough Erica David Flowers
Schaaf Courtni Nora Tan-Ngo
Seaborn Chelsea Jonathan Nguyen
Shafer Kristi Lisa Ortenzi
Shaw Marissa Jeffrey Oyler
Smith Allison George Stickney
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APRN Last APRN First Middle Delegating Physician Name
Smith Natacha Martin Johnson
Srickland Thomas David Shore
Stidham David Jaymal Patel
Taylor Leslie Leslie Taylor
Taylor Tania Licheng Tian
Toulon Gina Keith Michael
Toussaint Athara Tangela Atkinson
Troyer Peggy David Harvey
Tucker Kristin Ellen Courson
Turner Tiffanie Denis Morin
Tyus Brittney Darrell Surratt
Unogo Cindy Catherine Christie
Van Horn Rachel Jennifer Jones
Walker Jill David Lovejoy
Walton Candace Richard McIncrow
Warren Felecia Richard Cunnigham
White Julie Tam Nguyen
Williamson Trina David Flowers
Womble Taurus Mrunalee Mehta
Wood Miranda Bradley Morganstern
Yates Brittany Julian McClendon
Zmaj Andrea Lynette Wilson-Phillips
Any Old/New Business
Asked the staff to send a letter to Dr. Patel about the exemptions and number of NP’s he is
supervising.
PHYSICIAN ASSISTANT ADVISORY COMMITTEE
Dr. Antalis presented the Physician Assistant Committee report
The Board took the following actions:
Approve the following applications for initial licensure with a supervising physician:
PA
Supervising Physician
Benedict, Kathleen Molina, Adolfo
Catherwood-Bartholomew, Gwen Laskar, Sonjoy
Daker, Wesam Thankachan-Jacob, Arun
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Edenfield, Christopher Gard, Dwayne
Habte, Rebecca Ahmad, Rukhsana
Hughes, Sean Wolfe, Christopher
Jagun, Erica Bress, Joel
Metz, Rachel Hazel, Robert
Patel, Devina Thames, Todd
Schneider, Kyle Roepke, Thomas
Yarima, Salihu Solitario, John
Approve the following application for initial licensure with a supervising physician pending
additional information:
PA Supervising Physician
Joseph, Anish Warner, John
Approve the following application for initial licensure with a supervising physician pending
renewal of NCPAA Certification:
PA Supervising Physician
Rawlinson, Bryan Miller, Alan
Approve the following applications for initial licensure without a supervising physician:
PA
Almeida, Michelle
Aponte-Torres, Beatriz
Baggett, Bobbie
Beckmon-Forrester, Brittney
Black, Christina
Bos, Michelle
Bross, Morgan
Cheema, Jamshaid
Francois, Patrick
Hatcher, Jessica
Kwarteng, Sandra
Peterson, Elanor
Romanello, Tiffany
Webb, Julie
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Advise the following to withdraw initial application without a supervising physician due to
underlying circumstances:
PA
DB
Approve the following applications for reinstatement with a supervising physician:
PA Supervising Physician
Advise the following to withdraw application for reinstatement without a supervising physician
application due to restricted license in other states:
PA
AEB
Approve the following Add/Change applications:
PA Supervising Physician
Abebe, Beniam Falconer, Walter
Alexander, David Hardee, Michael
Attawala, Rauha Patel, Nipun
Benz, William Williams, Robert
Bertrand, Lakiesha Butler, Caroline
Blair, Emory Sharif, Shan
Blessing, Lauren Mandalapu, Kamal
Bloodsaw-Scott, Lashonda Dairo, Dokun
Bloodsaw-Scott, Lashonda Amene, Philippa
Boyer, Derek Supple, Nichole
Bunt, Janice Bedell, Sidney
Byrd, Kelsey Prather, John
Cammon, Thomeshia Wood, Robert
Carstens, Nicholas Nygren, Henry
Cilimberg, Matthew Ki Wan, Kim
Cogburn, Rallie McCullough, Ricky
Coulter, Darrin Haddad, Sinan
Craig, Chanelle Naccarato, Sergio
Davis, Donica Abbott, John
Duval, Rosmary Katkoori, Devendar
Edwards, Roxanne Peng, Vincent
Erusiafe, Kevwe Buelvas, Raul
Erusiafe, Kevwe Schwartz, Stephen
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Ferjuste, Fedlande Toro, Gyula
Florez, Joana Rubin, Tod
Florez, Joana Okanlawon, Olutoyin
Gist, Julian Okanlawon, Olutoyin
Godfrey, Angela Richey, Wayne
Grifis, Georgia Harding, Susan
Hall, Kevin Okanlawon, Olutoyin
Hall, Kevin Fabayo, Adesola
Hall, Kevin Beatty, James
Hammond, Karen Mohammad, Fawzi
Hartley, Krysta Srinagesh, Prasanna
Hass, Christopher Stirton, Jacob
Hayes, Ashley Ford, Alexcis
Heard, Matthew Wooley, Rahim
Hedden, Allison Nixon, Bruce
Hernandez, Andres Zeidan, Ronnie
Jamail, Brian Faile, George
Jennings, Ronald Claps, Charles
Johnston, Lucas Torres, Arturo
Johnston, Lucas Varias, Jon
King, Melanie Gilman, Cary
Koopal, William Dyer, Rupert
Lack, Kevin Collins, James
Layfield, William Price-Jackson, Christina
Lewis, Stephen Kang, Brandon
Li, Jianmei Patel, Gaurav
Little, Richard Glenn, Robert
Littlefield, Wayne Gray, Arthur
Lux, Naomi Jordan, William
Makin, Shannon Johnson, Joe
Marbury, William Howe, Danielle
McClure, Melissa Frederick, John
Melnik, Larissa Connell, Cymanthia
Mikronis, Zacharias Torres, Arturo
Montana, Armando Fields, Jayson
Morrison, James Ma, Christopher
Nelson, Suzanne Francis, Woody
Olansen, Nancy Kenning, Tyler
Page, Bradley Lee, Clay
Patel, Apexa Titlman, Robert
Perry-Davis, Carla Hwang, Lily
Pineda, Nicolai Smith, Luke
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Pineda, Nicolai Smith, Elizabeth
Rice, William Newfield, William
Robinson, Terry Hamilton, Joy
Roush, Andrew Black, Steven
Rush, Christa Ravi, Ajay
Schuler, Shelley Gray, Leslie
Schutz, Douglas Khaldoon, Al-Moosawi
Sedor, Gregory Bradley, Caitlin
Sharma, Amit Rogers, Ryan
Shinabarger, Andre Gilliam, Jessica
Snyder, Elizabeth Manu, Yaa
Snyder, Elizabeth Chai, Young
Sonders, Leslie Refai, Daniel
Stephenson, Julia Sridharan, Marandapalli
Stevens, Gregory Morris, Jonathan
Stevens, Gregory Cheever, Bryan
Stoker, John Burke, Michael
Stubbs, Karin Rubin, Tod
Thomas, Alexa Kim, David
Thomas, Omokayode Grube, Matthias
Toussaint, Eddy Sellers, Marty
Tucker, Kenya Barlatt, Crispin
Von Der Schulenburg, Amanda Page, Eugenia
Vu, Tram Whitmore, Morgan
Weaver, Adam Evans, Charles
Weaver, Adam Barrett, Alina
White, Blaise Torres, Arturo
Willauer, Eva Bapat, Amol
Williams, Gregory Armenia, Robin
Willoughby, Kenneth Jasper, Travis
Wood, Michael Black, Steven
Approve the following Additional Duty Request:
Misty Banknell, PA with – Dr. Mark Bonner
Injection of Dermal Fillers
Injections of Botox
Karen Hammond, PA with – Dr. Fawzi Mohammad
Insertion of Tunneled Central IV Access
Bibi Haniff, PA with – Dr. Stephen Frohwein
Stress Testing
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Tony Lynn Herring, PA with –Dr. Richard P. James
Injection of Botox
Performance of Chemical Peels
Injection of Dermal Fillers
Aubrie Mathewson, PA with – Dr. Steven Niergarth
Arthrocentesis of the Knee
Intra-Articular Injections of the Hip
Intra-Articular Injections of the Knee
Intra-Articular Injections of the Shoulder
Intra-Articular Injections of the Sacroiliac Joint
Intra-Articular Injections of the Carpometacarpal Joint
Lacey McLendon, PA with Dr. John Barton
Gastrojejunoostomy Tube Exchange
Liver Biopsy
Pleurx Insertion
Nephrastomy Tube Exchange
Marcus Parker, PA with Dr. Arthur McCain
Plueurx Placement
Fluid Aspiration
Liver Biopsy
Drain Placement
Image Guided Non-Vascular Tube Change/Replcement
Jennifer Vincent, PA with – Dr. John Layher
Cardiac Stress Testing
Request the following to submit 240 shadowing hours:
PA
TS
Other Business:
1. CAA business venture scope of practice inquiry. Full Board Review
2. Compose written guidelines for PA's licensed in Georgia who work in federal facilities
regarding the following:
- Add/Change requirements that differ when both the Supervising Physician and Physician
Assistant hold Georgia licenses.
- Statement or policy specifying we do not have jurisdiction over DEA requirements for both
Federal and non-Federally employed Physician Assistants in Georgia. PA Committee agreed
to provide guidelines.
COSMETIC LASER ADVISORY COMMITTEE
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Dr. Gross presented the Cosmetic Laser Committee report as a motion and it carried
unanimously.
The Board took the following actions:
Approved the following for Assistant Laser Practitioner –
Tatiana Castillo
Katherine Canzoneri
Kyoung Ok Choi
Amy Coker
Victoria Dabbs
Lexi Giles
Heather Livingston
April Marcum
Megan Polichnowski
Approved the following for a reissue of Assistant Laser Practitioner –
Laura Hill
Stephanie Lawson
Peggy Mills
Approved the following for Senior Laser Practitioner –
Ragan Gaskin
RESPIRATORY CARE ADVISORY COMMITTEE
Dr. Dalton presented the Respiratory Care Committee report as a motion. The Board accepted
the report by unanimous vote.
The Board took the following actions:
Correspondence
1. The Committee proposed changes to the RCP rules and guidelines. Changes will be
presented to the Rules Committee for review next month.
2. The Committee denied requests for extensions of temporary licenses.
Reinstatements:
Dalis, Abigail- pending additional information
Dempsay, Jessica
Holt, Deanna- pending additional information
McCarthy, Michael
Pruitt, Latorie
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Temple, Kimberly
Walker, Devonie
Temporary:
Barber, Ryan
Benson, Noah
Edmond, Tiffany- pending additional information
Floyd, Angela
Gay, Kayla
Harris, Shekina
Jolly, Shacorea
Kelly, DeAngela
Lamar, Kendra
Morton, Dakota
Reese, Courtney
Wells, Tina
Full Licensure:
Carr, Ada
Dauphin, Betsy
DeVivo, Jennifer- pending additional information
Horner, Renee- pending additional information
Jenness, Vincent- pending additional information
Moneit, Marissa
Newell, Annis
Rosenhoover, Lauren
Soeun, Yien- pending additional information
Administrative Upgrades
1. Krishna Patel
2. Davarrio Worthy
3. Rhianon Mangan
4. Ashley N. Martin
5. Olivia Kile
6. Ashley Brooks
7. Melissa Moss
8. Timothy Harris
9. Kimalyn Scott
10. Emmalee Albritton
11. Casey Mimbs
12. Raela Meadows
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13. Chaston Weaver
14. Jenna Foster
15. Jennifer Harris
16. Rifath Rashid
17. Hannah Faulkner
18. Deborah Plaines
19. Erin Sterling
20. Ann Marie Do
21. Jessica Davila
22. Rachel Harris
23. Patrick Mitchell
24. Melat Kebede
25. Isabel Diaz-Guerrero
26. Samuel Mathis
27. Brandi Jones
28. Mary Gibbs
PERFUSION ADVISORY COMMITTEE
Dr. Retterbush presented the Perfusion Committee report as a motion. The Board accepted the
report by unanimous vote.
The Board took the following actions:
Approved the following applications for Initial Perfusion licensure:
Yana Ivasko
Daniel Rodriguez
ACUPUNCTURE ADVISORY COMMITTEE
Mr. Law presented the Acupuncture Advisory Committee report as a motion. The Board
accepted the report by unanimous vote.
The Board took the following actions:
Accepted the quarterly reports for the following:
Terrence Park
Invite JHL for an interview with the Committee and to provide a complete documented work
history since completion of education.
Other Business:
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Board staff to reply to email from Susan O’Neill to notify her that medical records for
acupuncture patients must be maintained for ten (10) years.
PAIN MANAGEMENT COMMITTEE
Dr. Simmons presented the Pain Management Committee report as a motion. The Board
accepted the report by unanimous vote.
The Board took the following actions:
Application Pain Clinic Name
547601 Specialty Spine and Pain, P.C.- Buford
Reinstatement License # 155 Georgia Pain and Wellness- Atlanta
Approved pending $10,000 fine for unlicensed practice
License # 155 Georgia Pain and Wellness- Atlanta
Request to Change Name
The Committee approved the following applications that were Administratively Approved
License # Pain Clinic Name
269 Ellis Pain Center-Watkinsville
Add Practicing Physician, Christopher Sellars
Delete Practicing Physician, Terrance Hughes
License # Pain Clinic Name
224 Harbin Clinic, LLC-Rome
Add Physician Assistant, William Johnson
Delete APRN, Serena Moss
364, 485 Neurological Spine and Pain
Add APRN, Kelli Hendley
118 Center for Spine and Pain
Add APRN, Kasie Barrett
116 Georgia Pain and Spine Care
Add Practicing Physician, Ashna Parti
520 Serenity Spine Center-Springfield
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Add Physician Assistant, Kayla Hill
326 Alliance Spine and Pain Centers
Delete Practicing Physician, Myrlynn Delille
279 The Nexus Pain Center of Columbus
Delete APRN, Magenia Janney
Delete APRN, Christopher Garner
Revise Hours
416,418 Alliance Spine and Pain Centers
Delete Practicing Physician, Ashna Parti
324 Alliance Spine and Pain Centers
Delete Practicing Physician, Myrlynn Delille
328 Alliance Spine and Pain Centers
Delete Practicing Physician, Shahnaz Bari
234,235,451,
pending F547601 Specialty Spine and Pain, PC
Add APRN, Emily Brooks
Other Business:
1. Should the Medical Board charge a fee to add APRN’s who fall under rule OCGA 43-34-
23, but do not have protocol agreements with delegating physician(s) nor prescribe
controlled substances?
• The Committee recommended board staff continue with current policy for
APRN’s.
2. The Add, Delete, Revise Pain Clinic application is 6 pages. The last page is the Personnel
Certification Form (Background Check info). If an applicant is deleting a physician, does
this page need to be included?
• The Committee recommended board staff revise and update the Add, Delete,
Revise Pain Clinic application.
GENETIC COUNSELORS ADVISORY COMMITTEE
Dr. Deloach presented the Genetic Counselors Advisory Committee report.
The Board took the following actions:
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1. The Committee reviewed and discussed some questions presented by applicants.
2. The Committee agreed that the meeting time for future meetings will be at 6:00p.m.
3. The Committee reviewed and discussed the following question presented by an applicant
and need the full Board’s input.
Question: I'm not currently employed as a genetic counselor, but I will need to provide
genetic counseling services as part of my job. My direct supervisor is not a physician.
Should I leave the physician's information blank on the reference form? Where should
my supervisor sign if she is not a physician?
Board staff updated the reference form for the signature area to include physician or
certified genetic counselor.
ORTHOTIST & PROSTHETIST ADVISORY COMMITTEE
Dr. DeLoach presented the Orthotist & Prosthetist Advisory Committee report.
The Board took the following actions:
Approved the following applications:
Scott Annis – Initial Dual O&P (Mr. Walker recused.)
Kori Campbell – Upgrade to Dual O&P
LAW ENFORCEMENT ADVISORY REPORT
Phyllis Douglas, Legal Services Officer, presented the report as a motion. Dr. Marshall
seconded. The Board accept the report by unanimous vote.
1. M.K., MD; A.A., MD – Approved to release the records, redact confidential information
2. 20191025 – Approved to release the records
3. A.O., MD – Approved to release the records
4. L.F., MD - A.M., APRN – Approved to release public information only
5. 20162046 – Denied request to release the files; request must come directly from agency
WELLNESS COMMITTEE
Dr. Harbin presented the Wellness Committee report as a motion and Dr. Simmons seconded.
The Board accepted the report by unanimous vote:
a. PHP report
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b. Non-Interview Matters:
a. 20200426 – Review request for second opinion after voluntary release from PHP.
Recommendation: If failure to report to GA PHP, agree to interim
suspension/summary suspension due to evaluation.
b. 20200519 – Review self-report prescribing complaint and discuss with GA PHP
Recommendation: Follow guidelines for GA PHP.
c. Interview Matters:
a. 20171205 –
Recommendation: Agreed to follow recommendations from treating physician,
and submission of advocacy letters from therapist and primary care doctor.
b. C.R., M.D. – Application for reinstatement. Application responses required
additional information and follow-up. Recommendation: Accept Licensure
recommendation.
INVESTIGATIVE INTERVIEW REPORT
Dr. Marshall presented the Investigative Interview report as a motion, and was seconded by Dr.
Retterbush. The Board accepted the report by unanimous vote.
The Board took the following actions.
20192069 AGNOH 20192425 LOC
20181575 TABLE 20190551 LOC
20191888 CLOSE 20192014 PEER
20192172 CLOSE
INVESTIGATIVE COMMITTEE
The Investigative Committee report was presented as a motion by Dr. Retterbush and was
seconded by Dr. Harbin. The Board accepted the report by unanimous vote.
The Board took the following actions.
Close:
20150119 20150910 20161915 20162402 20171480 20172007
20181306 20182210 20190072 20190140 20190269 20191703
20191827 20191911 20192000 20192121 20192300 20192335
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20192383 20192421 20192434 20192477 20192482 20192483
20192511 20192557 20192558 20192559 20192588 20192594
20192602 20192617 20200043 20200045 20200084 20200106
20200141 20200142 20200157 20200161 20200165 20200194
20200201 20200222 20200249 20200261 20200262 20200265
20200266 20200267 20200273 20200276 20200280 20200293
20200298 20200300 20200309 20200343 20200429 20200438
20200443 20200491 20200518 20200534 20200574
Close with Letter of Concern:
20171385 20181343 20181760 20190455 20191839 20191940
20192260 20192392 20192465 20192498 20192514 20192516
20192517 20200051 20200085 20200274 20200315 20200579
Invite for Investigative Interview:
20170011 20190853 20192138 20192200 20192509 20200376
20200506
Further Investigation:
20172321 20180067 20190380 20192412 20200284
Table
20191934 20192353 20192544 20200268
Attorney General’s Office
20160160 20200474 20181187 20182263 20160061
Peer Review
20181856
OMPE
20190560 20190598
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INITIAL COMPLAINT EVALUATIONS The Board approved the following recommendations.
20200537 20200557 20200569 20200571 20200583 20200584
20200585 20200586 20200587 20200589 20200592 20200593
20200594 50500595 20200603 20200604 20200612 20200615
20200617 20200654 20200676 20200674 20200682 20200684
RECUSALS DeLoach 20182210
Marshall 20200141
There being no further business, motion Dr. Retterbush, seconded Dr. Weil voted to adjourn the
meeting at 4:04pm.
__________________________________ _____________________________________
Gretchen Collins, MD LaSharn Hughes, MBA
Chairperson Executive Director
Recorded by:
_______________________________________________
Phyllis White, Executive Assistant