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GEORGIA COMPOSITE MEDICAL BOARD

MINUTES

NOVEMBER 1-2, 2012

The Georgia Composite Medical Board (GCMB) held its regular meeting on November 1-2,

2012 at 2 Peachtree Street, NW, 36th

Floor, Atlanta, Georgia 30303, to consider Medical Board

matters:

Board Members in attendance on Thursday, November 1, 2012

William Butler, MD, Chairperson

John S. Antalis, MD

Gilbert Chandler, MD

Daniel DeLoach, MD

Alexander Gross, MD

Kathy Kemle, PA Ex-Officio Board Member

Kathy Kinlaw, Consumer Member

Marion O’Neil Lee, MD

Cami McGarity, Consumer Member

Trey Powell, MD

David Retterbush, MD

William Sightler, DO

Board Members absent on Thursday, November 1, 2012

Alice House, MD

Richard Weil, MD

Wendy Troyer, MD

Representatives from the Attorney General’s Office

Janet Wray, Senior Assistant Attorney General

Amelia Baker, Senior Assistant Attorney General

Wylencia Hood Monroe, Senior Assistant Attorney General

Reagan Dean, Senior Assistant Attorney General

Dr. Butler called the meeting to order at 8:00 a.m.

AGENDA

Motion Ms. Kinlaw, seconded by Dr. Lee, to approve the Agenda of the November 1-2, 2012

meeting. The motion carried unanimously.

MINUTES

Motion Dr. Gross, seconded by Dr. DeLoach, to approve the minutes of the October 4-5, 2012

Board meeting. The motion carried unanimously.

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JEFF LANE’S RETIREMENT RECOGNITION

Ms. Hughes reminded the Board that this meeting is Jeff Lane’s last meeting. Dr. Butler, Chair,

thanked Mr. Lane for his faithful service to the Board and the citizen of Georgia. The Board and

staff gave Mr. Lane a standing ovation for his service.

WELCOME NEW DIRECTOR

Mr. Tony Winborn, incoming Director of Investigations was introduced to the Board. Dr. Butler

performed the swearing in ceremony for Mr. Winborn.

EXECUTIVE DIRECTOR’S REPORT

LaSharn Hughes, Executive Director represented the following information for review:

The Board voted to have the January 2013 Board meeting at Mercer University Campus Field

House in Macon.

Prescription Monitoring Program – the contract should be awarded after the first of the year.

Physician Health Program (PHP) update – The Board sent letters to 39 licenses whom were

eligible for the admittance to the PHP, out of the 39 – 19 enrolled and 20 opted out. The Board

will include information regarding the PHP on identification cards for physicians and physician

assistants.

Letter from Terence L. O’Rourke, Jr. MD – regarding his refusal to submit immigration

documents and his desire to put his license on inactive status; the Board agreed to allow him to

place this license on inactive status.

Letter from John Culverhouse – inquiring how the adoption of Rule 360-3-.07 would make it

easier to utilize telemedine and receive reimbursement.

Letter inquiring when does the patient relationship end? The Board responded that the physician

must send the patient a letter terminating the physician patient relationship or if the patient has

not been evaluated or treated the patient for a period of at least two (2) years.

The Board accepted the following as information:

Health Insurance Exchanges – Georgia Health Policy Center

Article “Congress extends visa waiver program for IMGs.”

Article “Washington Doctor’s license permanently revoked for not cooperating with

investigation.”

Article Scope Newsletter – “GSA hails new Physician Health Program.”

Article “GA Reps urge CMS to reconsider CRNA pain rule.”

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Federation of State Medical Board regarding call for nominations for officers for the upcoming

year.

The Board discussed a request to be a part of clinical trials for Patient Qualification Review

Panel. The Board voted to inform the individual that this Panel is no longer functioning.

RULES HEARING

The Board comments on rules posted from interested parties on the following rules:

Dr. Gross made a motion seconded by Dr. Lee to adopt the proposed Rule 360-2-.14

“Requirements for Approval of International Medical Schools” to find the formulation and

adoption of this rule does not impose excessive regulatory cost on any licensee and any cost to

comply with the proposed rule cannot be reduced by a less expensive alternative that fully

accomplishes the objectives of the applicable laws.

That the Board find that it is not legal or feasible to meet the objectives of the applicable laws to

adopt or implement differing actions for businesses as listed at O.C.G.A 50-13-4 (a) (3) (A), (B),

(C), and (D).

Dr. Gross made a motion seconded by Dr. Retterbush to adopt the proposed Rule 360-15-.01

“Requirements for Physicians” and to find the formulation and adoption of this rule does not

impose excessive regulatory cost on any licensee and any cost to comply with the proposed rule

cannot be reduced by a less expensive alternative that fully accomplishes the objectives of the

applicable laws.



(C), and (D).

The Board heard comments on Rule 360-3-.02 “Unprofessional Conduct Defined and 360-3-

.07 Practice Through Electronic or Other Such Means.” The Board will vote on this rule at

the December 6, 2012 meeting.

ADJOURN

Dr. Gross made a motion, seconded by Dr. Antalis, to adjourn until the completion of

investigative interviews. The motion carried unanimously.

RECONVENED

Dr. Butler declared the meeting in open session at 3:00 p.m.

APPLICATION QUESTIONAIRE INITIAL & RENEWAL

Motion Dr. Powell, seconded Dr. Retterbush to approve the following language for initial

renewal, and reinstatement applications:

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INITIAL/REINSTATEMENT During the last 7 years, have you suffered from any physical, psychiatric, or substance use

disorder that could impair or require limitations on your functioning as a (replace with

profession name, i.e. physician assistant, physician, etc….), or has resulted in the inability

to practice medicine for more than 30 days, or required court-ordered treatment or hospitalization?

NOTE: You DO NOT need to answer YES to this question if you are enrolled in the Georgia

Physicians Health Program.

RENEWAL:

During the last two years, or since your last renewal, have you been diagnosed or treated for:

a. Alcohol or drug dependency?

_____Yes _____No or enrolled in the GAPHP

b. Any mental or neuropsychological disorder?

_____Yes _____No

If Yes, briefly describe below and submit treatment documentation with your renewal form.

CLOSED MEETING

Motion Dr. Gross, seconded Dr. Lee and motion carried to go into close session to discuss

Investigate and Wellness matters:

LAW ENFORCEMENT ACTION REPORT

Dr. Gross made a motion, seconded Dr. DeLoach to accept the following report. The motion

carried unanimously. The Board took the following actions:

1. Request from AC for a letter from the Board stating that he has not filed a complaint -

approve request

2. Request from DEA for the names of all PAs past and present, working, or have worked for a

pain center. – share information.

3. 20111775 – Accept Consent Order.

4. 20121268 – Accept Consent Order




8. 20120955 – Accept Inactive Status

9. 20041074 & 20051541 – Deny removal of information from physician profile.

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10. 20120628 – Refer to Attorney General’s Office

11. 20130406 – Accept Consent Order.

12. 20130328 – Accept Consent Order and allow to renew.


14. 20111286 - Tabled

15. 20111124 – Request approved

16. 20100656 – Tabled

17. 20040164 – Refer to AG

18. 20100539 – Tabled

ADJOURN

Dr. Lee made a motion, seconded by Dr. Gross to adjourn and reconvene Friday morning.

Motion carried unanimously.

The Meeting adjourned at 4:30 p.m.

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GEORGIA COMPOSITE MEDICAL BOARD

MINUTES

NOVEMBER 1-2, 2012

RECONVENED

Dr. Butler called the meeting to order at 8:00 a.m.

Board Members in attendance on Friday, November 2, 2012

William Butler, MD, Chairperson

John S. Antalis, MD

Gilbert Chandler, MD

Daniel DeLoach, MD

Alexander Gross, MD

Kathy Kemle, PA Ex-Officio Member

Cami McGarity, Consumer Member

Trey Powell, MD

David Retterbush, MD

Board Members absence on Friday, November 2, 2012

Alice House, MD

Kathy Kinlaw, Consumer Member

Marion O’Neil Lee, MD

William Sightler, DO

Wendy Troyer, MD

Richard Weil, MD

Charles White, DO

Representative from the Attorney General’s Office

Janet Wray, Senior Assistant Attorney General

RULES HEARING

Dr. Gross made a motion seconded by Dr. Lee to adopt the proposed Rule 360-2-.05 “Renewal

Applications” and to find the formulation and adoption of this rule does not impose excessive

regulatory cost on any licensee and any cost to comply with the proposed rule cannot be reduced

by a less expensive alternative that fully accomplishes the objectives of the applicable laws.



(C), and (D).

Dr. Gross made a motion seconded by Dr. Retterbush to adopt the proposed Rule 360-2-.07

“Reinstatement” and to find the formulation and adoption of this rule does not impose

excessive regulatory cost on any licensee and any cost to comply with the proposed rule cannot

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be reduced by a less expensive alternative that fully accomplishes the objectives of the applicable

laws.

ADVISORY COMMITTEE REPORTS

ACUPUNTURE ADVISORY COMMITTEE REPORT

Dr. Gross presented the report of the Acupuncture Advisory Committee. Dr. Antalis seconded

the Committee’s motion and it carried unanimously.

The Committee made the following recommendations to the Board:

Accept NCCAOM exam score for:

Chah, Maria

Accept the following Quarterly Report:

Huh, Cameron

Approve the following applicant for initial licensure:

Ana Villanueva

Approve the following applicant for reinstatement of licensure:

Alice Honican

Approve request for withdrawal of application:

Steingraber, Marcia

PHYSICIAN LICENSING AND PROFILES ADVISORY COMMITTEE REPORT Dr. Gross presented the report of the Physician Licensing and Profiles Advisory Committee. Dr.

Butler seconded the Committee’s motion and it carried unanimously.

The Board took the following actions:

1. Tabled the following applications:

J.D.

J.R.

F.G.

2. Refer to Wellness:

C.S.

3. Allow to Withdraw:

M.K. M.I.

4. Approved requests for Waivers of Rule 360-2-.02 for the following applicants:

McCorvey, David

Naqvi, Sheba

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5. Approved the following for Reinstatement of Licensure:

1. Cliatt, Thomas DO - 55932

2. Davis, Sanford MD - 56094

3. Harrison, David Glenn MD- 33348

4. Norris, Jeanette MD- 34678

5. Parikh, Sunil MD - 54642

6. Spiltalny, Neil MD - 51388

6. Other Business:

a) Gudapati, Rao - Refer applicant to FSMB to request Flex Transcript for score transcript.

b) Molina, Armondo - Approved request to send information to NM Medical Board.

c) Khalil, Magdy – Denied request to provide primary source documents to another State

Board.

d) Haque, Nabila - Approved request to retake Step 3.

e) Foley, Sean - Denied request to accept verification from another Board.

f) Leum, Carl - Approved request to send information to Idaho Medical Board.

7. Approved the following applications for physician licensure:

LIC_NBR NAME Designation

68847 PITA, MARK ANTHONY MD

68848 PHILIBERT, ROBERT ALAN MD

68849 PALLE, SIRISH K MD

68850 PATEL, KAVITA MD

68851 PENALVER, ALBERTO ANGEL MD

68852 RUDOLPH, PRIYA MD

68853 SABOLICH, MARKO ANTON MD

68854 SAMUEL, AMBER MD

68855 SHARMA, DIPIKA MD

68856 SIMPSON, ANDREW MD

68857 SINGLETON, DANIEL HARPER MD

68858 STOKES, TASHAWNA DENISE MD

68859 THOMAS, CYMANTHIA KEESHA MD

68860 TRONCONE, STEVEN KERR DO

68861 UY, CLARENCE N MD

68862 VUKELIC, SASA MD

68863 WALTON, ZEKE JONATHA MD

68864 WANG, LUOQUAN MD

68865 WATSON, GEORGE R MD

68866 WEEKS, WOODWIN MICHAEL DO

68867 WENGER, FRED GRIGGS JR DO

68868 WILLIAMSON, DAVID KELLEY MD

68869 WIMBUSH, TRACY ELIZABETH MD

68870 YE, DONGJIU MD

68871 ZLOTNIK, RICHARD D MD

68872 ZAKHIREH, MOHAMMED ALI MD

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68873 ADAMSKI, JOHN HENRY II MD

68874 ADLER, JEFFREY BRIAN MD

68875 AFRIDI, ZAHID MD

68876 AGRAWAL, RUCHIR MD

68877 ALI, BAKHTIAR MD

68878 ALURKAR, AJEY SASHIKANT MD

68879 BARALT, DIANA MARIA MD

68880 BAUDOIN, DEREK MD

68881 BOYD, CHARLES MONTGOMERY MD

68882 BRADDOCK, DEMETRIOS MD

68883 BRODERSEN, MARK PRESTON MD

68884 BUTALA, RAJESH M MD

68885 COPPOLA, MICHAEL MD

68886 CORREOSO-THOMAS, LYLA JANEIL MD

68887 DARKWA, NANA YAW ASANTE MD

68888 DAYAN, STEPHEN ALAN MD

68889 DIAZ, ENRIQUE MD

68890 ELLIS, DAVID HOWARD DO

68891 EDGEWORTH, MICHAEL L MD

68892 DZIUBAN, ERIC JOSEPH MD

68893 FARRAG, TARIK Y MD

68894 FIGUEROA, ESTUARDO MD

68895 FISHER, KEVIN EDWARD MD

68896 FRENCH, MARSHALL LEVON MD

68897 GARZA, JOSE MIGUEL MD

68898 GILMAN, JORDANA SARAH MD

68899 GLEASON, BRIANA CLAIRE MD

68900 GLOGOVER, PHILIP HERBERT MD

68901 GONE, KAVITA REDDY MD

68902 GOTTLIEB, SIDNEY OTTO MD

68903 GRIFFITH, KENDALL MARCUS MD

68904 GRIFFITH, MICHELE YOLANDA MD

68905 GRIMM, CHELSEY LEIGH MD

68906 LYNN, CHRISTINA PITTS MD

68907 ONWUMERE, IKENNA U MD

68908 LEE, JOO WON MD

68909 LAZZARO, BETSY MD

68910 HENRY, ARNOLD FAUNTLEROY MD

68911 LANE, ZHAOLI MD

68912 MEADOWS, TODD JASON MD

68913 MARGOLES, LINDSAY MARGARET MD

68914 OUTERBRIDGE, YI-HWA MD

68915 HENDRICKS, LATONYA MICHELLE DO

68916 NOVAK, JOSHUA DANIEL MD

68917 HUNLEY, CHARLES FRANKLIN MD

68918 LEE, POSHING MD

68919 HAWTHORNE, KINJI LOTHARIO MD

68920 JONES, CHELSEA RAE MD

68921 JACOBSON, SIG-LINDA MD

68922 NAQVI, SHEBA MD

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68923 MAGLOIRE, MARIA ZITA FRANCISCA MD

68924 MILLER, CELESTE MD

68925 KRAMER, MICHAEL KEVIN MD

68926 ISOM, JOEL TERRANCE MD

68927 MARSHALL, TRISTA J MD

68928 OUTTEN, STEPHEN SINCLAIR DO

68929 HALL, DANNY MD

68930 LEVERETT, BARBARA MILLER MD

68931 MAYS, WILLIAM RANDOLPH MD

68932 MILLER, ALAN B MD

68933 MOOK, WILLIAM RANDOLPH MD

68934 MCKNIGHT, AISHA JENELLE MD

68935 LECKIE, STEVEN KOUFMAN MD

68936 SHARIF, RAMLA MD

68937 DESAI, SUDHEN BIHARI MD

68938 GOODWIN, ALYSON MD

PHYSICIAN ASSISTANT ADVISORY COMMITTEE

Dr. Sighter presented the report of the PA Advisory Committee. Dr. Gross seconded the

Committee’s motion and it carried unanimously.

The Committee made the following recommendations:

1. Approve the following additional duties requests:

Physician Assistant Additional Duties Requested

1. Kathleen Boettcher 1. Stress Test

2. Lauren Fogelgren 1. Lumbar Puncture with Intrathecal

Chemotherapy

2. Bone Marrow Aspirate

3. Bone Marrow Biopsy

3. Georgia Griffis 1. Botox/Fillers

4. Jessica Hart 1. Botox/Fillers

5. Jon Khoury 1. Central Lines

2. Paracentesis

3. Toracentesis

4. Vascualr Catheter Placement

Physician Assistant Additional Duties Requested

6. Katherine Perry Thyroid Ultrasound

7. John Plourd 1. Nerve Conduction Studies

8. Greg Steahr 1. Arterial Lines

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2. Central Lines

3. Pulmonary Artery Catheters

9. Phan Tasco-Anderson 1. Cosmetic Botox injections

2. Filler Injections

3. Chemical Peels (light to moderate)

4. Mircroderabrasions

5. Sclerotherapy

2. Table the following additional duty request:

1. Phan Tasco-Anderson 1. Venus Freeze Medical Device

3. Approve the following applications for initial licensure

Physician Assistant Supervising Physician

Jonathan Beck Steven Disch, MD

Caroline Bond Nicole Sroka, MD

Harmony Church Angela Bookout, DO

Justin Clack Carter Co, MD

Whitney Cobb William Watkins, MD

Kate Courtney Michael Sopt, MD

Sarah Craven John Edsworth, MD

Maggie Dear Michael Hulse, MD

Kimberly Dykeman Nibdita Patro, MD

Casey Farris Jay Kher, MD

Karen Ferguson Mark McLaughlin, MD

Bethany Gilley Michael Ikler, MD

Grace Hall Jeffrey Kovacic, MD

Lindsay Howard Stephanie Hsu, MD

Jarrod Luttjohann Ronald Perry, MD

Amanda McCook Dennis Harper, MD

Charishma Nayyar Mark Sultan, MD

Samantha Nowak Carroll Cooper, MD

Laura Oliver Richard Rowe, MD

Sejal Patel Sharon Amaya, MD

Alicia Provenzano Asif Qadri, MD

Ernest Rinaldi Ruchir Khuraha, MD

Mark Roman Hope McDaniel-Desarmes, MD

Brittany Stanczak Victor Zubar, MD

Courtney Stevens Jeffrey Winge, MD

Questa Tait Charles Mitchell, MD

Rodger Wagoner Anthony Hoots, MD

Charice Wilson Millard Collier, Jr., MD

4. Approve the following applications to add or change supervising physicians

PA/Name Previous Phy Phy/Name

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Ann Abercrombie Sharma Amit, MD Dennis Ricketts, MD

Abigail Afshari Paul Hawkins, MD Willis McVay, MD

Emily Baise-Shuman Ortelio Bosch, MD Jeffrey Kingsly, DO

Caroline Bliven Jimmy Hewitt, MD Jason Alisangco, MD

Willie Booker Matthew Andeldis, MD Eric Davis, MD

Michael Boyd Jin Yang, MD Jimson Smith, MD

Ashla Bryant Luther Vance, MD Van Millin, DO

Alaina Burran Gerald Slagel, MD Joseph DeVeau, MD

Barbara Burk Mary Hughes, MD Thomas Seay, MD

Charle Cameron Jenaine Oliga , MD Michael Ross, MD

Meghan Campbell Woody Francis, MD Fidias DeLeon, MD

Harold Caraviello, Jr Kenneth Rice, MD Jerry Williams, Jr., MD

Brian Daitch Bozeman Sherwood, MD Jerry Wilborn, MD

Brandi Daniel Kennon MCLendon, MD Christopher Morgan, MD

Robert Darsey Andrew Long, MD Bradley Walter, MD

Gregory Davis Sharron Thompson, MD David Smith, MD

Gilian Dudley James Seward, MD Gary Godlewski, MD

Brian Foster Murray Robinson, MD Howard Chandler, MD

Morgan Gallagher Don Shaffer, MD David Clifford, MD

Dipsy Gandhi Bradford Gould, MD Lei Cheng, MD

Christie Gibson Robert Gantt, MD Manojna Sanjeev, MD

Kristine Germann Maureen Olson, MD Todd Schmidth, MD

Tanya Green Eric Deal, MD James Gore, MD

Georgia Griffis Marcus Roberts, MD Eugene Jackson, MD

Clifton Gunter Pamela Weigandt, MD Daniela Rusu, MD

Alex Harris Eduardo Molinary, MD John Stauffer, MD

Jessica Hart Kevin Neibaum, MD Eugene Jackson, MD

Kimberly Hart Shelly Samuel, MD David Nussbaum, MD

Terry Harwood Zeeba Siddiqi, MD Paul Murray, MD

Mark Houtson Denis Trto, MD Daniela Rusu, MD

Tommy Jackson Scott Barbour, MD John Hastings, III, MD

Mary Jones Jerrold Levy, MD Jay Johansen, MD

Andrew Kelly Christopher Whitson, MD Markus Klass, MD

Jeninne LaCroix Thomas Fitzgerald, MD Richard Warren, MD

Jeffrey Lambert Robert Cox, MD William Fackler, MD

Hugh McCollum Christopher Nichols, MD Martha Schuh, MD

Markeita McIntosh Tracey Lemon, MD Marin Honore’, MD

Markeita McIntosh Tracey Lemon, MD Stanton McKenna, MD

Markeita McIntosh Tracey Lemon, MD Nana Opare, MD

Marjorie McKeller Hillary Hahm, MD Suepy Chen, MD

Dorthea Mackey Vinod Sachdeva, MD Chiquita Fye, MD

Patricia Mackey Michael Katz, MD Kenneth Johnson, MD

Anthony Medina Philip Henderson, MD Joel Zivot, MD

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Terry Mize Theresa Berry, MD B. Wayne Blount, MD

Katherine Perri Cameron Nixon, MD James Graham, MD

Alexander Polsinelli Jamie Lin, MD John Vance, Jr., MD

Leah Reynolds Donald Davis, MD Jeffrey Goldberg, MD

Lani Roberts Jessica McCoun, MD Jodi Kuhlman, MD

Gilliam Robinson David Walker, MD Charles Ruis, MD

John Schmidt Patrick Railey, MD Viviana Goldenberg, MD

Dennis Short Otis Tillman, MD Jovito Estaris, MD

John Simms Charles White, MD Daniel Lopez, MD

Greg Steahr James Kauten, MD Joseph Ricotta, MD

Greg Steahr James Kauten, MD Brenda Hott, MD

Jejuan Stewart Tom Roberson, MD Karen Carlson, MD

Keenan Templeton Michael Maynor, MD Franklin Payne, MD

Kathryn Thatcher Bruce Depiev, MD Stephen Pohl, MD

Mariah Thaxton Salil Patel, MD Darryl Harris, MD

James Todd James Snow, MD Adam Lewis, MD

Julia Varnier Hany Helmi, MD Pricilla J. Ross, MD

Leeann Vrabel Mary Sparks, MD Stephen Pohl, MD

Rachel Youngblood Stanley Shin, MD Christopher Haberman, MD

Derek Walker John Quina, MD Robert G. Hollenbeck, MD

Freda Wall Sheryl Vickery, MD Howard Chandler, MD

5. Approve the following Reinstatement Application:

a. William Chandler

6. Other Business:

a. The Committee reviewed the additional duties request for D.K. and recommended

tabling pending further information.

b. The Committee recommended presenting a list of tasks which are not considered

additional duties to the Board for approval.

c. The Committee recommended to accept the revision of Rule 360-5-.11

(Standards for Physician Assistant Practice) with changes.

New Proposed Rule:

(6) While engaged in medical practice, a physician assistant must clearly identify

himself as such. He/she must also wear a clearly legible identification name tag

with the words “Physician Assistant” on it. A Physician Assistant is to be

addressed as Mr., Mrs., Ms., or Miss.

d. The Committee reviewed the General Job Description (Form F) and agreed to

accept.

e. The Committee reviewed a letter from N.W. and agreed to refer to the Board for

consideration.

f. The Committee reviewed the update to online renewal question and agreed to the

changes.

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g. The Committee met with C.C. and recommending tabling the application until

successful completion on Pance Exam, 240 hours of shadowing with Supervising

Physician and monthly monitoring reports.

PERFUSION ADVISORY COMMITTEE

Dr. Retterbush presented the report of the Perfusion Advisory Committee. Dr. Powell seconded

the Committee’s motion and it carried unanimously.


1. Approve the following application for Perfusion Licensure:

a. Miguel Garcia

b. Joel Keene

c. Mark Moreau

2. Other Business:

a. The Committee recommended tabling to a future date:

Concern that Abiomed Impella Circulatory Support System and the TandemHeart

CardiacAssist Extracorporeal Circulatory Support System are being operated by

cardiac catheterization lab technicians.

b. The Committee recommended that B.B. submit a request for provisional licensure

and provide the Provisional Statement of Supervision Form ( Form F)

RESPIRATORY CARE ADVISORY COMMITTEE

Dr. Sightler presented the report of the Respiratory Care Advisory Committee. Dr. Antalis

seconded the Committee’s motion and it carried unanimously.


1. Approve the following applicants requesting 12-month permits:

Okefenokee Technical College - pending Education verification

1. Davis, Kimberly

2. Hodges, Joshua

3. Medders, Farris

4. Taylor, Marlee

5. Tisby, Denise

6. Treat, Christy

7. White, Clarice

8. Williams, Monica

1a. The Committee reviewed the following applicants for licensure:

a. Malcolm, Elvis - recommended for a 12 month permit

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b. Myrtyl, Pascal - recommended for a 12 month permit pending receipt of 15 CEU’s in

Critical Care & completion of Reference form B

2. Approve the following applicants requesting licensure by reciprocity:

1. Morlino, Allison

2. Patricia Spencer - pending Reference form & 15 hours of CEU’s in Critical Care

3. Approve the following applicants for licensure by reinstatement:

1. Burke, Ann

2. Dacosta, Angel - pending 15 CEU’s in Critical Care

3. Hebert, Jay - pending state verification from SC

4. Houghton, Herbert - pending Reference form

5. Moore, Brian

4. Review of the following applicants for Permanent licensure:

1. Wynn, Morgan

2. Young, Steven

5. The following applicant appeared before the RCP Advisory Committee for an interview:

1. Watkinson, Amanda - recommended for licensure by Reciprocity

6. Approve of the following applicants for full licensure:

1. Ahmed, Maria

2. Boyd, Danielle

3. Bruner, Mary

4. Chadwick, Tiffany

5. Collins, William

6. Crews, Jeremy

7. Haralson, Christa

8. Hiers, Hannah

9. Johnson, Shonquita

10. Medders, Ryan

11. Poole, Barry

12. Quach, Minh

13. Ray, Ashley

14. Sherman, Mariana

15. Thornton, Presley

7. Other Business

1. The Committee discussed graduates who were granted Respiratory care licensure in

Georgia whose license has expired or lapsed and are re-applying for licensure, but

unable to obtain Reference from a previous Medical Director or find a Prospective

employer to complete the Reference form B and recommended revising the Reference

form B.

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2. The Committee discussed Robert Williams request for reinstatement of licensure and

recommended to grant licensure.

ORTHOTICS & PROSTHETICS ADVISORY COMMITTEE

Dr. Antalis presented the report of the Advisory Committee. Dr. Deloach seconded the

Committee’s motion and it carried unanimously.


1. Approve the following applicants for Orthotic licensure:

a. Finney, Delana

b. Miller, Taavy

Other Business

1. The Committee discussed O.C.G.A. 43-34-193(12) (whether a Pedorthist can do

AFO’s) and recommended to table for discussion at our December 2012 meeting.

ADVANCED PRACTICE NURSE ADVISORY COMMITTEE

Dr. Gross presented the report of the Advisory Committee. Dr. Deloach seconded the

Committee’s motion and it carried unanimously. he Board took the following actions:

1. The Board voted that the following APRN Protocol Agreements met the provisions of

OCGA 43-34-25:

APRN Last Name APRN First Name Delegating Physician

Adams Angela D. Asit K. Jha, MD

Anderson Tabatha Kecia Jones, MD Arrington John Matthew Wheatley, MD

Asa Michele Betsy S. Horton, MD

Barnette Katherine Matthew A. Wheatley, MD

Barrington Elizabeth Najaz Woods-Bishop, MD

Bartock Dawn Shawn Jobe, MD

Baughcum Milissa B. Kelly C. Grow, MD

Berg Shawna Gaye Hayes,MD

Biglow Anicia S Bharatkumar Patel, MD

Blackburn Billie Carol Bozeman Sherwood, MD

Bonk Donna M. Raymond R. Jarvis, MD

Bracewell Joanne E Lourdes B. deArmas, MD

Brown Michelle Angela J. Hale, MD

Browne Vickie H. Ralph C. Lyons, MD

Byars Terri Brooksbank, Roger MD


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Campbell Joyce Denise Workman, DO

Ceasar Robbyn Clark, Curtis, MD

Cercone Elizabeth A. Robert E. Springer, MD

Chambers Donna Hussanin, Hina MD

Chessor Misty L. Jason Hefner, MD

Chetty Sundari Soyoola, Emmanuel MD

Clayton Brandi Baldwin, Richard MD

Cline Nyla Manley, Suzanne MD

Conley Gail Rao, Ramana MD

Croft Sheilia H. Reden C. Delgado, MD

Cummings Thelma B. Beverly Hyacinth, MD

Davis Lindsey N. Louis E. Hempel, MD

Denny Jean M. William E. Richards, MD

Driver Walline Wiley, Zanthia

Dupree Susan Lee Kenneth J. Howard, MD

Elrod Lean Neises, Kerry MD

Evans Natalie F. Alice R. House, MD

Fegely Karen J. Lee D. Jacobs, MD

Freeman Karen Christopher Recknor, MD

Gore Holly Dasher, William MD

Hale Tina Marie John C. Blankenship, MD

Hale Jessi Modi, Anil MD

Hammond Heather C. Bryan L. Philbrook, MD

Harley Dorthy Clyde Simmons, MD

Hedrick Caroline Rami Azzouz, MD

Hern Cynthia Susan Alfonso, MD

Holton Cynthia Higgins, Peter MD

Hull Melanie Kogan, Brian MD

Hurst Sabine C. Joseph D. DeVeau, MD

Jasper Lisa Gail Matthews, MD

Jennings Melindia Arnall, David MD

Jordan Sarah J.L. Raymond E. Gutierrez, MD

Kalm Heather Wheatley, Matthew MD

Kelker Cassandra Wallace Duncan, MD

Kelker Cassandra David Asrael, MD

Kerr Joanna Romualda Klicius, MD

Kerr Lakisha J. Howard Stirne, MD

Lee Erin Ramsdell, Bruce MD

Leigh Stacy Dennis Wiles, MD

Little Deborah J. Asad Hatem, MD


18

Loeffel Laura Jean Antonius J. DeGrauw

Lopez Melanie B. Paul A. Martin, MD

Macera Tana Thomas Hobby, DO

Mann Linda J. Michelle Morgan, DO

McCollough Michael A. Joseph D. DeVeau, MD

McKay Angela Shirley, Victoria DO

McLendon Angela Buice, Thomas MD

Mekhoukh Jennifer Randy Yada, MD

Meyers Michelle Chandra, Anuj MD

Miller Jenifer Narashimhulu Neelagaru, MD

Millsap Lori Safia Pirani, MD

Mitchell Joan Cox-Thompson, Jackie MD

Moore C. Meredith Kenneth Taylor, MD

Oess Barbara Zorn, William MD

Outz Mary A. David A. Stone, MD

Page Douglas Brian Jordan, DO

Parrish Wendy Douglas Epps, MD

Pearce Robin John Gott,MD

Powell Pamela W. Michael C. Pinell, MD

Quattlebawn Adrian M Courage ATEKHA, MD

Ragland Kenya Jeffrey Oyler, MD

Robinson Lisa William Lynds, MD

Robinson Shannon Morris Pulliam, MD

Ruiz Oscar James Beiter, MD

Sanchez Victoria Shameka McElhaney, MD

Sayewich Laura John Bleacher, MD

Scoggins Kelly W. Greg Schlegel, MD

Shaw Lauren T. Cedric Porter, MD

Shea Kimberly Savage, Valeria MD

Shedd Cheryl Rios, Antonio MD

Simpson Utopia Vitaliy Gavrikov, MD

Smith Daniel J. Anthony J. Marchetti, MD

Smith Cassie Quzu, Farid MD

Smith-Vaughn Melissa Roger Brooksbank, MD

Springman Courtney Kogon, Brian MD

Stier Ingrid Kaveh Ehsanipoor, MD

Sumner Erin Israel B.D. Bryson, MD

Tarver Pamela Christopher Kang, MD

Taylor Wendy L. Warren J. Henderson, MD

Tenebruso Lillian Anurag Kumbham, MD


19

Thompson Margaret Martinez, Manuel MD

Thrasher Mary A. Mark Elam, MD

Trouille Lori Steven Dawson, MD

Vanderburg George Brooksbank, Roger MD

VanPatten Laura Deering, Thomas MD

Von Herbulis Kelly A. Bradley S. Buckler, MD

Ward Sandra Charles Semones, MD

Webb Leah James Palazzolo, MD

Whaley Shelby Quinton Weldon, MD

Wood Patricia A. Robert D. Mixson, MD

Woods Jennifer Dania Atif Iqbal, MD

Yerke Julie Roger A. Brooksbank, MD

2. The Board voted that the following APRN Protocol Agreements met the provisions of OCGA 43-34-25 pending additional information.:

Adebayo, Monsurat Jada Bussey-Jones, MD,

Griffin, Shuvory Edwin Allen, MD,

Harley, Dorothy Clyde Simmons, MD,

Hart, Rebecca Costrini, Anthony MD

Jones, LaQuay Stinnette, William MD

Jones, LaQuay Blake, Bryan MD,

Kline, Gail Winston Jeshuran, MD

Merritt, Marcie Philip Reece, DO

Parks, Melissa Jay Schecter, MD

Perry, Venester Patel Roshni, MD

Povolny, Angela Bernertine King, MD

Singleton, Dawn Kesha Allen, MD

Sommers, Tanya Thomas Pantino, MD

Stemp, Linda Blake, Bryan MD

Stemp, Linda Stinnette, William MD

Watson, Donna Christopher Stevens, MD

Investigative Committee

Close the following cases:

20121311 20121387 20121581 20121612 20121653 20121788

20122027 20122034 20120056 20130116 20130229 20130421

Close the following cases with letter of concern:

20120875 20121016 20121019 20121189 20121416 20121740

20101334

Table the following cases:

20120955 20121768

20

Refer the following case to AG:

20110819 20120129 20120430 20120513 20130428 20111487

20130095 20130533 20130535

Invite for interview the following cases:

20120849 20120863 20121145 20121577 20121866 20122021

20121871

Cease & Desist on the following cases:

20121270 20121282 20121841 20121972

AG-OMPE on the following cases:

20130206 20130531 20130305

Initial Malpractice Evaluations:


20130109 20130168 20130239 20130240 20130498 20130543

20130544 20130546

Close and Flag the following case:

20130536

Initial Complaint Evaluations:


20100776 20100594 20110890 20111057 20111938 20120350

20120502 20120617 20120842 20120932 20120936 20121017

20121031 20121347 20121364 20121390 20121637 20121642

20121674 20121699 20121703 20121714 20121722 20121737

20121741 20121777 20121791 20121878 20121962 20121973

20122055 20122067 20130007 20130018 20130025 20130026

20130029 20130050 20130053 20130060 20130064 20130075

20130089 20130106 20130111 20130118 20130119 20130143

20130146 20130153 20130187 20130193 20130202 20130210

20130218 20130226 20130227 20130257 20130317 20130325

20130398 20130402 20130407 20130409 20130430 20130436

20130437 20130443 20130457 20130460 20130462

Close with letter of concern the following Initial Complaints:

20121100 20121344 20121488 20121518 20121552 20121560

20121601 20121687 20121695 20121996 20121877 20122013

20130087 20130142 20130183 20130209 20130291 20130298

Investigative Interview Report

21

20120197-PEER REVIEW

20111739-RESCHEDULED

20101008-CLOSE W/LOC

20121213-REFER TO AG

20110729-TABLED

20121504-TABLED

20130391-CLOSE

20112212-TABLED

20121436-CLOSE

20121811-CLOSE

20120281-CLOSE

20121299-CLOSE




20120909-TABLED

20121756-NO SHOW

20110689-CLOSE

20111095-CLOSE

20120997-TABLED

20120787-CLOSE

0120500-TABLED


WELLNESS COMMITTEE

Status report given by representative of the GA PHP.

1. Review probation and monitoring cases for suitability for referral to the GA PHP.

2. Case # 20100378-Table

3. Case # 20100768-Acknowledge receipt of information

4. Case # 20112015-(1) Cease and Desist and notify that that the Board requires new

supervisor. Dr. Lee and Dr. Chandler recused.

5. Case # 20121060-Terminate ANTP.

6. Case # 20101497-Deny request for modification.

7. Case # 20121256-Deny request for approval of particular treatment program

8. Committee notified of enrollment in the GAPHP

a) Case #20101451-Terminate Order

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b) Case # 20091527-Terminate informal monitoring

c) Case #20070007-Terminate Consent Order.

d) Case #20110445-Terminate Order

9. Case # 20122011-Terminate ANTP

10. Case # 20122032-Terminate ANTP

11. Case # 20111988-Terminate CO

Adjournment

There being no further business, motion Dr. Retterbush, seconded Dr. Gross and motion carried to

adjourn the meeting at 10:18 a.m.

_________________________________

William Butler, MD

Chair

__________________________________

LaSharn Hughes, MBA

Executive Director

Recorded and typed by LaSharn Hughes, Executive Director.

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