arizona medical board€¦ · facility lictype license num licensee status start date end date...

Post on 30-Oct-2019

2 Views

Category:

Documents

0 Downloads

Preview:

Click to see full reader

TRANSCRIPT

Facility Lictype License Num Licensee Status Start Date End Date

College of Medicine, Mayo Clinic 1908 R75872 Abdel-aty Yassmeen Active 07/01/2016 06/30/2017

1908 R75898 Abdelwahab Elhamahmi Dina . Active 07/01/2016 06/30/2017

1908 R74602 Abdul Muhsin Haidar M Active 07/01/2016 06/30/2017

1908 R75285 Aime Victoria Lynnae Active 07/01/2016 06/30/2017

1908 R75889 Al-Saffar Farah Isam Abdul... Active 06/30/2016 07/01/2017

1908 R75335 Allen Sorcha Active 07/13/2016 07/12/2017

1908 R75256 Arca Karissa Nicole Active 07/01/2016 06/30/2017

1908 R74635 Aye Wint Thant Active 07/01/2016 06/30/2017

1908 R75861 Babb Benjamin Albert Active 07/01/2016 06/30/2017

1908 R75300 Bailey Christopher Harold Active 07/01/2016 06/30/2017

1908 R74164 Bannis Kareem Active 07/08/2016 06/30/2017

1908 R75862 Bering Jamie Lauren Active 07/01/2016 06/30/2017

1908 R75879 Blech Benzion Chaim Yitzch... Active 07/01/2016 06/30/2017

1908 R75859 Breite Matthew Dennis Active 07/01/2016 06/30/2017

1908 R75857 Carlin Rachel Elizabeth Active 07/01/2016 06/30/2017

1908 R73755 Carvajal Carvajal Tomas Active 06/29/2016 06/28/2017

1908 R74587 Chiang Chia - Chun Active 07/01/2016 06/30/2017

1908 R75257 Christiansen Michael Erin Active 07/01/2016 06/30/2017

1908 R75258 Chuu Andy Active 07/01/2016 06/30/2017

1908 R75259 Conover Zacherie Robert Active 07/01/2016 06/30/2017

1908 R73331 Day Ryan William Active 06/30/2016 06/29/2017

1908 R75856 Delafield Nathan Lechase Active 07/01/2016 06/30/2017

1908 R75858 Dhanik Arjun Active 07/01/2016 06/30/2017

1908 R75260 Fega Kathryn Active 07/01/2016 06/30/2017

1908 R75778 Fleck Andrew R Active 07/01/2016 06/30/2017

1908 R75912 Franklin Taft Joseph Active 10/29/2016 10/29/2017

1908 R75925 Funk Eric Cornelius Active 02/25/2017 02/25/2018

1908 R74596 Gamez Haro Mauricio Emilio... Active 07/01/2016 06/30/2017

1908 R75290 Gervais Charles Active 07/01/2016 06/30/2017

1908 R75424 Giorgakis Emmanouil Active 07/01/2016 06/30/2017

1908 R73724 Greene Nina Active 07/01/2016 06/30/2017

1908 R75975 Gurrieri Carmelina C Active 04/03/2017 05/26/2017

Page Number 1 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

College of Medicine, Mayo Clinic 1908 R75873 Hall Scott Ryan Active 07/01/2016 06/30/2017

1908 R75306 Hangge Patrick Active 07/01/2016 06/30/2017

1908 R74600 Hansen Daniel Alexander Active 07/01/2016 06/30/2017

1908 R75899 Hilal Talal Active 07/01/2016 06/30/2017

1908 R75877 Hill Hannah Elizabeth Active 07/01/2016 06/30/2017

1908 R74915 Hoang Peter Thanh Active 07/01/2016 06/30/2017

1908 R75863 Horsley Robert Kenneth Active 07/01/2016 06/30/2017

1908 R75931 Hsu Ying-han Active 01/16/2017 01/16/2018

1908 R75886 Imam Sarah Sophia Active 07/01/2016 06/30/2017

1908 R75875 Jamison Dale Kenneth Active 07/01/2016 06/30/2017

1908 R75939 Jayaprakash Namita Active 12/31/2016 12/30/2017

1908 R75936 Jones Derick David Active 04/01/2017 03/31/2018

1908 R75261 Kaur Tripta Active 07/01/2016 06/30/2017

1908 R75389 Keeney Michael Gary Active 01/16/2017 01/15/2018

1908 R75960 Khoury Nadeen Active 03/13/2017 03/12/2018

1908 R75882 Kingston William Spencer Active 07/01/2016 06/30/2017

1908 R75977 Kiyofuji Satoshi Active 04/03/2017 06/30/2017

1908 R75434 Konik Ewa Agnieszka Active 05/16/2016 05/16/2017

1908 R75253 Kung Shu Ting Active 07/01/2016 06/30/2017

1908 R75866 Lacy Curtis Ray Active 07/01/2016 06/30/2017

1908 R75101 Lara Nina Jeanette Active 07/08/2016 06/22/2017

1908 R74172 Lee Justin Zon Ern Active 07/01/2016 06/30/2017

1908 R75878 Lehrer Michael David Active 07/01/2016 06/30/2017

1908 R75367 Lindor Rachel Alice Active 01/03/2017 01/02/2018

1908 R74769 Liu Lora Ann Active 07/08/2016 06/30/2017

1908 R75864 Maddux Jacob Tyler Active 07/01/2016 06/30/2017

1908 R75870 Makovicka Justin Lee Active 07/01/2016 06/30/2017

1908 R75254 McGarvey Jonathan Active 07/01/2016 06/30/2017

1908 R75945 McKenna Timothy John Active 01/03/2017 01/02/2018

1908 R75255 Mehta Jaya Mohini Active 07/01/2016 06/30/2017

1908 R75286 Miglani Amar Active 07/01/2016 06/30/2017

1908 R75853 Molloy Michael John Active 07/01/2016 06/30/2017

Page Number 2 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

College of Medicine, Mayo Clinic 1908 R75865 Murad Douglas Alexander Active 07/01/2016 06/30/2017

1908 R75292 Murante Anthony Loren Active 07/01/2016 06/30/2017

1908 R74216 Murphy Katie Mary Active 07/01/2016 06/30/2017

1908 R75248 Nokes Brandon Thomas Active 07/01/2016 06/30/2017

1908 R73754 Nunez Nateras Rafael Aleja... Active 06/29/2016 06/28/2017

1908 R75994 O'callaghan Marissa E Active 03/21/2017 06/28/2017

1908 R75855 Ornelas Abbie Sabrina Active 07/01/2016 06/30/2017

1908 R75924 Pagani-Estevez Gabriel Lui... Active 01/30/2017 01/30/2018

1908 R75249 Parsons Christine Elyse Active 07/01/2016 06/30/2017

1908 R75250 Patel Sagar Shashi Active 07/01/2016 06/30/2017

1908 R75309 Patton Michael William Active 07/01/2016 06/30/2017

1908 R74599 Peng Xin Active 07/01/2016 06/30/2017

1908 R75913 Pennington Kelly Marie Active 10/29/2016 10/29/2017

1908 R75874 Pflibsen Lacey Rachel Active 07/01/2016 06/30/2017

1908 R75896 Poon Tiffany Active 07/01/2016 06/30/2017

1908 R76109 Rao Arpit Active 05/02/2017 05/31/2017

1908 R75289 Ravi Bheeshma Active 07/01/2016 06/30/2017

1908 R75888 Rayfield Corbin Alexander Active 07/01/2016 06/30/2017

1908 R73756 Rhee Daniel Hyun KYU Active 06/29/2016 06/28/2017

1908 R75876 Ritz Matthew L Active 07/01/2016 06/30/2017

1908 R75887 Rose Kyle Matthew Active 07/01/2016 06/30/2017

1908 R75429 Saleem Abdulaziz Mamdooh Active 08/01/2016 07/31/2017

1908 R75091 Sattur Mithun Guraraj Active 07/01/2016 06/30/2017

1908 R75334 Scotch Allison Hope Gathan... Active 07/01/2016 06/30/2017

1908 R75991 Scott Jennifer Active 03/21/2017 06/28/2017

1908 R75871 Scott Kelly Leigh Active 07/01/2016 06/30/2017

1908 R75247 Seaberg Preston Hamilton Active 07/01/2016 06/30/2017

1908 R75246 Sheaffer William Warren Active 07/01/2016 06/30/2017

1908 R75867 Shipman Justin Neal Active 07/01/2016 06/30/2017

1908 R75868 Smith Erin Michelle Active 07/01/2016 06/30/2017

1908 R75422 Sonbol Mohamad Bassam Active 07/01/2016 06/30/2017

1908 R75976 Springman Korey Kathleen Active 05/27/2017 07/01/2017

Page Number 3 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

College of Medicine, Mayo Clinic 1908 R75384 Stanich Jessica Ann Active 04/03/2017 04/02/2018

1908 R75562 Stoker Alexander David Active 07/01/2016 06/30/2017

1908 R75860 Stone Jonathan Brian Active 07/01/2016 06/30/2017

1908 R75282 Stull Lindsey Blair Active 07/01/2016 06/30/2017

1908 R75245 Swanson Leah Anne Active 07/01/2016 06/30/2017

1908 R74553 Tazi Nina Ngo Active 07/01/2016 06/30/2017

1908 R75382 Thornton Jonathan Mark Active 02/27/2017 02/26/2018

1908 R75244 Tran Khang Hoang Active 07/07/2016 06/30/2017

1908 R75869 Tseng Andrew Sean Active 07/01/2016 06/30/2017

1908 R75305 Valencia Sanchez Cristina ... Active 07/01/2016 06/30/2017

1908 R76108 Vazquez Do Campo Rocio Active 05/01/2017 05/26/2017

1908 R74790 Vengerovsky Alexander Active 01/28/2017 01/27/2018

1908 R75881 Wallace Alex Lee Active 07/01/2016 06/30/2017

1908 R75854 Webb Christopher Jospeh Active 07/01/2016 06/30/2017

1908 R75281 Weidner Tiffany Kay Active 07/01/2016 06/30/2017

1908 R74798 White Mariah L Active 02/13/2017 02/12/2018

1908 R75251 Yonan Yousif Active 07/01/2016 06/30/2017

1908 R75923 Zaquera Carvalho Diego Active 01/30/2017 01/30/2018

1908 R75880 Zaw Yuzana Active 07/01/2016 06/30/2017

1908 R75252 Zell Michael Alan Active 07/01/2016 06/30/2017

HonorHealth Scottsdale Osborn 1908 R75015 Choo Jean So Young Active 07/01/2017 06/30/2018

1908 R75016 Combs Kara Lynn Active 07/01/2017 06/30/2018

1908 R75560 DeGrio Arie Jase Active 07/01/2017 06/30/2018

1908 R75019 Garcia Ann Catherine Active 07/01/2017 06/30/2018

1908 R76084 Holman Bradley Active 07/01/2017 06/30/2018

1908 R74444 Kruger Tricia Marie Active 07/01/2017 06/30/2018

1908 R75020 La Rosa William Robert Active 07/01/2017 06/30/2018

1908 R75021 Powell Matthew Reed Active 07/01/2017 06/30/2018

1908 R76113 Wagner Glenn Travis Active 07/01/2017 06/30/2018

1908 R76114 Webb Jeremy Daniel Active 07/01/2017 06/30/2018

1908 R74445 Whallon Ralph Samuel II Active 07/01/2016 06/30/2017

1908 R76115 Wypiszynski Sarah D Active 07/01/2017 06/30/2018

Page Number 4 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

HonorHealth Scottsdale Thompson Peak Medical Center 1908 R75479 Bikowski Brandon Michael Active 07/01/2016 06/30/2017

1908 R75481 Chaudhari Harshad Kumar Active 07/01/2016 06/30/2017

1908 R75099 Lawson Benjamin O Active 07/01/2016 06/30/2017

1908 R75480 MacDonald Alexis Upton Active 07/01/2016 06/30/2017

1908 R75482 Petersen Jameson Ross Active 07/01/2016 06/30/2017

1908 R75478 Varadarajan Rangashree Active 07/01/2016 06/30/2017

Maricopa Medical Center 1908 R74736 Abdulqader Yasir Active 06/23/2017 06/30/2017

1908 R74691 Adipue Iris Amay Active 06/23/2016 06/22/2017

1908 R75171 Ahmad Mamuna Active 06/23/2016 06/22/2017

1908 R75619 Al Charakh Mohammed B. Active 06/23/2016 06/22/2017

1908 R75172 Al Marzooq Ali A. Active 06/23/2016 06/22/2017

1908 R74694 Al-Ani Muhsen Muneer Active 06/23/2017 06/30/2017

1908 R74692 Alani Mustafa A Active 06/23/2017 06/30/2017

1908 R75615 Albadwi Gheyath G Active 06/23/2016 06/22/2017

1908 R75617 Alcantar Daniel Contreras Active 06/24/2017 06/30/2017

1908 R75173 Alnaser Ammar Active 06/23/2016 06/22/2017

1908 R73870 Alt Rachel Louise Active 06/23/2016 06/22/2017

1908 R75174 Apstein Ted Elliott Active 06/23/2016 06/22/2017

1908 R74695 Attya Amira H Active 06/23/2017 06/30/2017

1908 R74696 Atwal Danish Active 06/23/2017 06/30/2017

1908 R73871 Azurdia Adrienne Renee Active 07/01/2016 06/30/2017

1908 R75175 Bajwa Inderjot K. Active 06/23/2016 06/22/2017

1908 R75177 Bollenbach Stephanie Elain... Active 06/23/2016 06/22/2017

1908 R75678 Bonfiglio Chelsea Caterino... Active 06/23/2016 06/22/2017

1908 R74717 Callow Samantha Myers Active 07/01/2016 06/30/2017

1908 R75179 Carter Ashley Elizabeth Active 06/23/2016 06/22/2017

1908 R75622 Chacon-lutrick Lucas Migue... Active 06/24/2017 06/30/2017

1908 R74698 Chea Kimberly Melissa Active 07/01/2016 06/30/2017

1908 R75181 Chundu Navya Active 06/23/2016 06/22/2017

1908 R74738 Cocco Daniela Active 06/23/2016 06/22/2017

1908 R74541 Colglazier Roy John Active 07/01/2016 06/30/2017

1908 R74078 Collins Michael Robert Active 07/01/2016 06/30/2017

Page Number 5 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

Maricopa Medical Center 1908 R75623 Considine Perrin Thalia Sa... Active 06/23/2016 06/22/2017

1908 R75262 Crowder Ashley Kristen Mil... Active 07/01/2016 06/30/2017

1908 R73877 Crowder Robert Thomas Jr Active 07/01/2016 06/30/2017

1908 R75182 Dahl Aaron J. Active 06/23/2016 06/22/2017

1908 R75681 Daldalyan Koruon Karen Active 06/23/2016 06/22/2017

1908 R74700 Dameff Christian Jordan Active 07/01/2016 06/30/2017

1908 R75183 Davies Callie Marlene Active 06/23/2016 06/22/2017

1908 R74701 Davis John Jr Active 06/23/2016 06/22/2017

1908 R75624 Demenna Jacob Thomas Active 06/23/2016 06/22/2017

1908 R73969 Dimick Whitney Active 07/01/2016 06/30/2017

1908 R73544 Djenic Brano Active 06/23/2016 06/22/2017

1908 R74702 Dobbe Daniel Richard Active 07/01/2016 06/30/2017

1908 R75243 Eakin Cortney Michelle Active 06/23/2016 06/22/2017

1908 R75242 Elango Vishalakchi Active 06/23/2016 06/22/2017

1908 R75241 Elias Ghazwan M. Active 06/23/2016 06/22/2017

1908 R75625 Fegale Benjamin Active 06/23/2016 06/22/2017

1908 R74703 Fisher Michael Anthony Active 06/23/2016 06/22/2017

1908 R75627 Fisher Ryan David Active 06/23/2016 06/22/2017

1908 R73963 Flores Carmen Elena Active 06/23/2016 06/22/2017

1908 R75240 Freiheit Derek Robert Active 12/01/2016 11/30/2017

1908 R74820 Garza-Cavazos Adrian Active 07/01/2016 06/30/2017

1908 R75984 Gibreel Waleed Active 02/23/2017 06/30/2017

1908 R74704 Godzdanker Iv Active 07/01/2016 06/30/2017

1908 R73967 Gustafson Jennifer Kathryn... Active 06/24/2017 06/30/2017

1908 R74705 Guynes Anthony James Active 07/01/2016 06/30/2017

1908 R75761 Harmon Tanner Jesse Active 07/01/2016 06/30/2017

1908 R75632 Harper Elizabeth Christine... Active 06/30/2016 06/29/2017

1908 R74706 Harris Holly Renee Active 07/01/2016 06/30/2017

1908 R74708 Hattab Bassam Talat Najeeb... Active 06/23/2016 06/22/2017

1908 R75682 Heck Maya Jasmine Active 06/23/2016 06/22/2017

1908 R75685 Helpling Rachel Alma Active 06/23/2016 06/22/2017

1908 R75239 Henderson Tarann M. Active 07/01/2016 06/30/2017

Page Number 6 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

Maricopa Medical Center 1908 R74709 Hodgson Nicole Rose Active 07/01/2016 06/30/2017

1908 R75180 Huliyar Radhika Active 06/23/2016 06/22/2017

1908 R75238 Hvidsten Kelsey Meghan Active 06/23/2016 06/22/2017

1908 R75635 Ibrahim Luma Abduljabbar Active 06/23/2016 06/22/2017

1908 R73984 Imam Basel Active 06/24/2016 06/23/2017

1908 R75637 Jaouen Brant Marcus Active 06/23/2016 06/22/2017

1908 R75025 Jugler Tanner Kris Active 07/01/2016 06/30/2017

1908 R74710 Kannan Vijay Christopher Active 07/01/2016 06/30/2017

1908 R75236 Kanwar Sandeep Active 07/01/2016 06/30/2017

1908 R75680 Keenan Jack Bohmont Active 06/24/2017 06/30/2017

1908 R75235 Kelly Christina De Baun Active 06/23/2016 06/22/2017

1908 R74711 Kim Edwin Active 06/23/2016 06/22/2017

1908 R74245 Kincaid Margaret Kathleen Active 07/01/2016 06/30/2017

1908 R74712 Kiyani Amirali F Active 06/23/2017 06/30/2017

1908 R73995 Kosinski Romero Kassandra ... Active 08/25/2016 08/24/2017

1908 R75184 Kracke Elsa Jane Active 06/23/2016 06/22/2017

1908 R75639 Kraus Anthony Emmanuel Active 06/23/2016 06/22/2017

1908 R75234 Krzeminski Sylvia Eve Active 06/23/2016 06/22/2017

1908 R75233 Kukkamalla Rene Meghana Active 07/01/2016 06/30/2017

1908 R74755 Larson Cody Roger Active 07/01/2016 06/30/2017

1908 R74713 Lau Andrew Chi-Heng Active 07/01/2016 06/30/2017

1908 R74714 Le Nicholas Hoang Active 06/23/2016 06/22/2017

1908 R74715 Lopez Angelena Reyes Active 06/23/2017 06/30/2017

1908 R75185 Lott Eric Stanley Active 06/23/2016 06/22/2017

1908 R74716 Lotz Scott William Active 07/01/2016 06/30/2017

1908 R75686 Malik Rameez Active 06/23/2016 06/22/2017

1908 R75642 Mann Dylan Dulya Active 06/23/2016 06/22/2017

1908 R75231 Meng Gharett Owen Active 07/01/2016 06/30/2017

1908 R75230 Metas Elyssa Marie Active 06/23/2016 06/22/2017

1908 R75229 Mikkilineni Anupama Active 06/23/2016 06/22/2017

1908 R75644 Moazez Caramel Mary Active 06/23/2017 06/30/2017

1908 R75530 Morkos El Hayek Sahar Active 06/03/2016 06/02/2017

Page Number 7 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

Maricopa Medical Center 1908 R74007 Mosley Aris Ellann Daniell... Active 06/24/2016 06/23/2017

1908 R75645 Naeem Arslan Active 06/23/2016 06/22/2017

1908 R75647 Najeeb Saba N Active 06/23/2016 06/22/2017

1908 R75650 Nicoll Brigham John Active 06/23/2016 06/22/2017

1908 R75652 Noori Tarreq Mohammad Active 06/23/2016 06/22/2017

1908 R75227 Nzuonkwelle Sumediah Active 06/23/2016 06/22/2017

1908 R75225 O'Brien Regan Victoria Active 06/23/2016 06/22/2017

1908 R75985 Odom Elizabeth Active 05/15/2017 05/29/2017

1908 R75224 Parrish Ashley Elizabeth Active 07/01/2016 06/30/2017

1908 R74524 Penny Scott Michael Active 07/01/2016 06/30/2017

1908 R74008 Placette Jacqueline Moniqu... Active 06/24/2017 06/30/2017

1908 R74719 Price James Robert Active 07/01/2016 06/30/2017

1908 R75654 Pugsley Paul Edwin Active 06/23/2016 06/22/2017

1908 R75655 Ramakuri Monica Active 06/23/2016 06/22/2017

1908 R75656 Ramos-jensen Whitney Active 06/30/2016 06/29/2017

1908 R75217 Rast Fawad Active 06/23/2016 06/22/2017

1908 R74720 Ravari Farrokh Active 06/23/2016 06/22/2017

1908 R75679 Raz Guy Michael Active 06/23/2016 06/22/2017

1908 R75683 Reeder Samantha Jo Hawley Active 06/23/2016 06/22/2017

1908 R74721 Rigdon Daniel Clark Active 07/01/2016 06/30/2017

1908 R75703 Rivera Paolo Lorenzo B. Active 06/23/2016 06/22/2017

1908 R76095 Robertson Lorraine Louise Active 05/01/2017 07/28/2017

1908 R75687 Robison Caitlin Marie Active 06/30/2016 06/30/2017

1908 R74004 Roh Albert Tae-Hun Active 07/01/2016 06/30/2017

1908 R75657 Romanu Rebekah Josephine Active 06/30/2016 06/29/2017

1908 R74722 Romero Raymond Anthony Fig Active 06/23/2017 06/30/2017

1908 R75216 Roy Babbitt Marie Frances Active 06/23/2016 06/22/2017

1908 R76058 Ruble Laura Mary Active 05/02/2017 05/16/2017

1908 R75214 Rudha Yasir Mohammad Fawz Active 06/23/2016 06/22/2017

1908 R75213 Runyan Charles Edwin III Active 06/23/2016 06/22/2017

1908 R75212 Saeed Zahid Mohammad Active 06/23/2016 06/22/2017

1908 R75727 Salem Mohammed Nasser Active 06/24/2017 06/30/2017

Page Number 8 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

Maricopa Medical Center 1908 R74723 Sehmbey Gurbir Singh Active 06/23/2016 06/22/2017

1908 R75728 Selzer Jordan Arthur Active 06/23/2016 06/22/2017

1908 R74740 Shah Anushi Raxit Active 07/01/2016 06/30/2017

1908 R75658 Shehzad Pir Active 06/23/2016 06/22/2017

1908 R75211 Shin Christopher Active 06/23/2016 06/22/2017

1908 R74724 Singh Sonam Active 06/23/2016 06/22/2017

1908 R75659 Sipe Michelle Vita Active 06/23/2016 06/22/2017

1908 R75186 Smith Adam James Active 07/01/2016 06/30/2017

1908 R75660 Srihari Priya Active 06/23/2016 06/22/2017

1908 R75531 Talamini Christine E Active 06/16/2016 06/15/2017

1908 R73883 Troxler Anna Gretchen Active 06/24/2016 06/23/2017

1908 R73882 Tugulan Carmen Ioana Active 06/23/2016 06/22/2017

1908 R74726 Turner Andrea Elizabeth Active 06/23/2016 06/22/2017

1908 R73452 Van Tassel Dane Carlisle Active 07/01/2016 06/30/2017

1908 R74727 Vandervelde Joel Christoph... Active 06/23/2016 06/22/2017

1908 R75210 Veltkamp Matthew Robert Be... Active 07/01/2016 06/30/2017

1908 R75760 Wallmann Andrew Caswell Active 06/23/2017 06/30/2017

1908 R75209 Watanabe Kyle Masao Active 07/01/2016 06/30/2017

1908 R74729 Weimer Samuel Brey Active 06/23/2016 06/22/2017

1908 R74730 Weinhold Orla Mary Active 06/23/2016 06/22/2017

1908 R73880 Weir Alexandra Susannah Sh.. Active 06/23/2016 06/22/2017

1908 R74731 Whelan Alexander Scott Active 07/01/2016 06/30/2017

1908 R73537 Winton Lisa Marie Active 06/23/2016 06/22/2017

1908 R75208 Wong Tina Wai-Ting Active 06/23/2016 06/22/2017

1908 R75688 Wright Robert Sean Active 06/23/2016 06/22/2017

1908 R72744 Wu Geena Xiangru Active 07/01/2016 06/30/2017

1908 R75661 Wu Henry Cheng-Ju Active 06/24/2016 06/23/2017

1908 R75684 Zeitjian Vicken Sarkis Active 06/23/2016 06/22/2017

1908 R74732 Zeki Dina Falah Active 06/23/2016 06/22/2017

Phoenix Baptist Hospital and Medical Center 1908 R75844 Agha Ahmed KM Active 07/01/2016 06/09/2017

1908 R75845 Amurao Miguel Carlo Active 07/01/2016 06/30/2017

1908 R75298 Donaldson Janelle Evans Active 07/01/2016 06/30/2017

Page Number 9 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

Phoenix Baptist Hospital and Medical Center 1908 R75847 Gonzales Miguel Roberto Active 07/01/2016 06/30/2017

1908 R74403 Haydu Joseph Arthur Active 07/01/2016 06/30/2017

1908 R75297 Hayes Kellen J Active 07/01/2016 06/30/2017

1908 R74404 Molyneux Melissa S Active 07/01/2016 06/30/2017

1908 R75296 Okafor Mark Chukwuamaka Active 07/01/2016 06/30/2017

1908 R74402 Overton Eric Scott Active 07/01/2016 06/30/2017

1908 R75295 Park Dalnam Active 07/01/2016 06/30/2017

1908 R75848 Raad Kareem Naji Active 07/01/2016 06/30/2017

1908 R75849 Rechul Dawid Robert Active 07/01/2016 06/30/2017

1908 R75846 Rechul Kisria Ann Active 07/01/2016 06/30/2017

1908 R74405 Virgil David Elias Active 07/01/2016 06/30/2017

1908 R75293 Von Detten Tanya Kalani Active 07/01/2016 06/30/2017

1908 R75850 Zhang Jing Qian Active 07/01/2016 06/30/2017

1908 R75294 Zweig Matthew Sterling Active 07/01/2016 06/30/2017

Phoenix Children's Hospital/Maricopa Medical Center 1908 R75605 Adusei Charity Active 06/23/2016 06/22/2017

1908 R74968 Ahmad Maria Mona Active 07/01/2016 06/30/2017

1908 R74423 Alfeche Robyn Louvena Active 06/23/2016 06/22/2017

1908 R75606 Armenta Brittany Nichole Active 06/23/2016 06/22/2017

1908 R75992 Bach Corrie Ruth Active 06/05/2017 06/30/2017

1908 R75136 Bahr Timothy Marvin Active 06/23/2016 06/22/2017

1908 R74425 Baker Sherry Marie Active 06/23/2016 06/22/2017

1908 R75607 Balaji Arvind Active 06/23/2016 06/22/2017

1908 R75608 Barshow Suzanne Marie Active 06/23/2016 06/22/2017

1908 R74438 Bennett Alysha L Active 07/28/2016 07/27/2017

1908 R75176 Bernau Lauren Michelle Active 06/23/2016 06/22/2017

1908 R75137 Bhatt Himali Harshad Active 06/23/2016 06/22/2017

1908 R74434 Bjornsen Brent Allen Active 06/23/2016 06/22/2017

1908 R74435 Blaskovich Teresa Rose Active 06/23/2016 06/22/2017

1908 R75609 Bodea Jessica Lynn Active 06/23/2016 06/22/2017

1908 R74436 Boucek Lisa Michelle Active 06/23/2016 06/22/2017

1908 R75769 Branca Aline Noelle Active 07/01/2016 06/30/2017

1908 R75162 Brown Yvette Michelle Active 06/23/2017 06/22/2018

Page Number 10 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

Phoenix Children's Hospital/Maricopa Medical Center 1908 R75942 Brush Thomas Patrick Active 01/01/2017 06/30/2017

1908 R75139 Campos Elizabeth Active 06/23/2016 06/22/2017

1908 R75145 Conover Katherine Courtney... Active 06/23/2016 06/22/2017

1908 R75610 Crooks James Norman Active 06/23/2016 06/22/2017

1908 R74951 Dance Logan R Active 07/01/2016 06/30/2017

1908 R75612 Duncan Eric William Active 06/23/2016 06/22/2017

1908 R75140 Erickson Jenna Rose Active 06/23/2016 06/22/2017

1908 R75613 Farag Amye Marie Active 06/23/2016 06/22/2017

1908 R75614 Farmer Adam Wallace Active 06/23/2016 06/22/2017

1908 R75885 Francis Sarah Elizabeth Active 07/01/2016 06/30/2017

1908 R75616 Frischknecht Adam Clair Active 06/23/2016 06/22/2017

1908 R75193 Gary Anna Josephine Active 06/23/2016 06/22/2017

1908 R74437 Giacone Heather Marie Active 06/23/2016 06/22/2017

1908 R75141 Gutierrez Whitney Clare Active 06/23/2016 06/22/2017

1908 R75142 Hall Jennifer Swan Active 06/23/2016 06/22/2017

1908 R74440 Haverland Joshua Alan Active 06/23/2016 06/22/2017

1908 R73794 Heim Jennifer Ashley Active 06/23/2016 06/22/2017

1908 R75364 Hickman Kyle Michael Jaeb Active 07/01/2017 06/30/2018

1908 R74640 Hodoba Nathaniel Blaine Active 06/23/2016 06/22/2017

1908 R75191 Hofman Ariel Renaye Active 06/23/2016 06/22/2017

1908 R75618 Hung Tracy Tsui Ying Active 06/23/2016 06/22/2017

1908 R74441 Irwin Lacy Dawn Active 06/23/2016 06/22/2017

1908 R74642 Julien Daniel Christopher Active 07/01/2016 06/30/2017

1908 R75982 Jundt Michael Curtis Active 04/24/2017 05/19/2017

1908 R75621 Kanafani Adam Active 06/23/2016 06/22/2017

1908 R75653 Kapadia Saher Norruislam Active 06/23/2016 06/22/2017

1908 R74456 Kehring Allysa Lauren Klem... Active 06/23/2016 06/22/2017

1908 R73663 Kelle Angela Marie Active 05/28/2016 05/27/2017

1908 R73783 Kennedy Melanie Alaina Active 06/23/2016 06/22/2017

1908 R73792 Keyser Emily Yeager Active 06/23/2016 06/22/2017

1908 R74457 Kripps Kimberly Ann Active 06/23/2016 06/22/2017

1908 R73351 Kulkarni Neil A Active 06/23/2016 06/22/2017

Page Number 11 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

Phoenix Children's Hospital/Maricopa Medical Center 1908 R75626 Kum Pamela Hun Yiu Active 06/23/2016 06/22/2017

1908 R74483 Lee Alice Moran Active 06/23/2016 06/22/2017

1908 R75143 Lorimer, Jr Dean Paul Active 06/23/2016 06/22/2017

1908 R74485 Luu Kevin Duc Active 06/23/2016 06/22/2017

1908 R75978 Maloney Patrick Ryan Active 05/01/2017 06/03/2017

1908 R75628 Mantrala Malica Deepti Active 06/23/2016 06/22/2017

1908 R75629 Matz Megan Sara Active 06/23/2016 06/22/2017

1908 R75630 McAnally Cady Michelle Active 06/23/2016 06/22/2017

1908 R75144 McClellan Ryan Scott Active 06/23/2016 06/22/2017

1908 R76013 McMahon Erika Hoenke Active 07/03/2017 07/28/2017

1908 R74501 Mecham Cherisse Active 06/23/2016 06/22/2017

1908 R75631 Moreira Axel Gerardo Active 06/23/2016 06/22/2017

1908 R75195 Morse Keith Ellis Active 06/23/2016 06/22/2017

1908 R75194 Moza Rohin Active 06/23/2016 06/22/2017

1908 R75636 Naille Lauren Active 06/23/2016 06/22/2017

1908 R74487 Nau Eric Donald Active 06/23/2016 06/22/2017

1908 R75146 Navarre Brittany Mary Active 06/23/2016 06/22/2017

1908 R74488 Neal Richelle Mary Active 06/23/2016 06/22/2017

1908 R75147 Niles Denver Trevyine Active 06/23/2016 06/22/2017

1908 R75148 Obradov Aleksandra Active 06/23/2016 06/22/2017

1908 R75651 Oh Ann Suen Hee Active 06/23/2016 06/22/2017

1908 R75138 Osborn Julie Active 06/23/2016 06/22/2017

1908 R75199 Patel Rinkal Raj Active 06/23/2016 06/22/2017

1908 R74489 Penn Natalie Christine Active 06/23/2016 06/22/2017

1908 R75794 Pfeifer Cory Michael Active 07/01/2016 06/30/2017

1908 R75152 Plesh Lauren Louise Active 06/23/2016 06/22/2017

1908 R76117 Powell Garret Michael Active 07/31/2017 08/25/2017

1908 R73787 Rabon Lydia Michelle Active 06/23/2016 06/22/2017

1908 R75153 Rakkar Jaskaran Active 06/23/2016 06/22/2017

1908 R75154 Rosado Jose Gabriel Active 06/23/2016 06/22/2017

1908 R74490 Roth Emily Vanessa Catheri... Active 06/23/2016 06/22/2017

1908 R75196 Ruffenach Stephen Charles Active 06/23/2016 06/22/2017

Page Number 12 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

Phoenix Children's Hospital/Maricopa Medical Center 1908 R75592 Russi Daniela C Active 08/08/2016 08/07/2017

1908 R75155 Sabella Colleen Marie Active 06/23/2016 06/22/2017

1908 R75633 Sachs Jonathan Walk Active 06/23/2016 06/22/2017

1908 R75634 Sanderson Michael Quintin Active 06/23/2016 06/22/2017

1908 R74498 Schell-Yates Tyler Ray Active 06/23/2016 06/22/2017

1908 R74484 Schmidt Corinne Lieu Active 06/23/2016 06/22/2017

1908 R75157 Schmieding Ashley Olivia Active 06/23/2016 06/22/2017

1908 R75638 Shane Romy Bianca Active 06/23/2016 06/22/2017

1908 R75768 Sheikhizadeh Ali Javod Active 07/01/2016 06/30/2017

1908 R75640 Shillington Jon Mark Active 06/23/2016 06/22/2017

1908 R75641 Sokolove Rebecca-lyn Active 06/23/2016 06/22/2017

1908 R75197 Solove Matthew Active 06/23/2016 06/22/2017

1908 R74491 Sood Arun Active 07/07/2017 07/06/2018

1908 R75192 Srivastava Amit Kumar Active 06/23/2016 06/22/2017

1908 R75643 Stamm John David Active 06/23/2016 06/22/2017

1908 R75159 Stewart Ryan Michael Active 06/23/2016 06/22/2017

1908 R74643 Teherani Meghan F Active 06/23/2016 06/22/2017

1908 R73795 Tokhie Harlori Kaur Active 06/23/2016 06/22/2017

1908 R75160 Tsin Cathy Mei Active 06/23/2016 06/22/2017

1908 R74492 Tully Jeffrey L Active 06/23/2016 06/22/2017

1908 R75646 Tung Chia-hsiang Active 06/23/2016 06/22/2017

1908 R74493 Uber Allison Nicole Active 06/23/2016 06/22/2017

1908 R74494 Vadasz Nataly Imbar Active 06/23/2016 06/22/2017

1908 R75648 Vala Aarti Active 06/23/2016 06/22/2017

1908 R74495 Vandervelde Kathryn Ault Active 06/23/2016 06/22/2017

1908 R75999 Waseemuddin Mohammed Active 08/01/2017 07/31/2018

1908 R74496 Weber Jennifer Chao Active 06/23/2016 06/22/2017

1908 R74497 Wickland Jessica Lynn Active 06/23/2016 06/22/2017

1908 R75706 Willard Scott David Active 07/01/2016 06/30/2017

1908 R75649 York Sara Michelle Active 06/23/2016 06/22/2017

1908 R74499 Zarlengo Dominic Joseph Active 06/23/2016 06/22/2017

1908 R74500 Zomer Crystal Dawn Active 06/23/2016 06/22/2017

Page Number 13 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

St Joseph's Hospital and Medical Center 1908 R74671 Abdel Hafiz Mohammed Active 07/01/2016 06/30/2017

1908 R75554 Adler Cameron Robert Active 07/01/2016 06/30/2017

1908 R75006 Ajisebutu Adekunle Oladega... Active 07/01/2017 06/30/2018

1908 R75749 Al Hasan Yazan Mahmoud Active 07/01/2017 06/30/2018

1908 R73457 Al Qaisi Saifuldeen Awf Ab... Active 07/01/2017 06/30/2018

1908 R75492 Albadri Mina Moayad Majeed... Active 07/01/2017 06/30/2018

1908 R75489 Allos Samir Sahim Active 07/01/2017 06/30/2018

1908 R72011 Almefty Rami Ossama Akram Active 07/01/2017 06/30/2018

1908 R74314 Anand Keshav Active 07/01/2017 06/30/2018

1908 R75763 Arora Kanika Active 07/01/2017 06/30/2018

1908 R75556 Bahadir Jenna Deniz Active 07/01/2017 06/30/2018

1908 R74877 Bailey Mark Ammon Active 07/01/2017 06/30/2018

1908 R75750 Balbuena-root Melissa Rene... Active 07/01/2017 06/30/2018

1908 R74673 Ballachanda Subbaiah Taara... Active 07/01/2016 06/30/2017

1908 R74997 Baranoski Jacob Francis Active 07/01/2017 06/30/2018

1908 R74931 Barbu Shadi Vida Active 07/01/2017 06/30/2018

1908 R74094 Barnes Dominique Michelle Active 07/01/2016 06/30/2017

1908 R75007 Barrett Aaron Cameron Active 07/01/2017 06/30/2018

1908 R74141 Beutler Richard K Active 07/01/2016 06/30/2017

1908 R74090 Bohl Michael Austin II Active 07/01/2017 06/30/2018

1908 R73514 Bowker Harold Dean III Active 07/01/2016 06/30/2017

1908 R75571 Brigeman Scott T Active 07/01/2017 06/30/2018

1908 R75558 Bryan Lynn Lisa Active 07/01/2017 06/30/2018

1908 R75988 Buller Mark Al Active 07/01/2017 06/30/2018

1908 R75762 Buller Mark Andrew Active 07/01/2016 06/30/2017

1908 R75515 Burton Meisje C'Sable Active 07/01/2017 06/30/2018

1908 R74924 Casino Geraldine Marapao Active 07/01/2017 06/30/2018

1908 R75567 Catapano Joshua Stephen Active 07/01/2017 06/30/2018

1908 R74921 Chan Justine Kit Active 07/01/2017 06/30/2018

1908 R75427 Chaudhary Anirudh Active 07/01/2017 06/30/2018

1908 R75001 Chen Edward Yuder Active 07/01/2017 06/30/2018

1908 R72477 Chen Tsinsue Active 07/01/2017 06/30/2018

Page Number 14 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

St Joseph's Hospital and Medical Center 1908 R74072 Chesteen George Vernon II Active 07/01/2017 06/30/2018

1908 R74881 Cole Tyler Scott Active 07/01/2017 06/30/2018

1908 R73580 Crain Ian Daniel Active 07/01/2016 06/30/2017

1908 R75460 Crete Ryan Nicholas Active 07/01/2017 06/30/2018

1908 R75566 Curole Justin Luke Active 07/01/2017 06/30/2018

1908 R74912 Dameworth Jonathan Lark Active 07/01/2017 06/30/2018

1908 R74674 Dasyam Sravya Active 07/01/2017 06/30/2018

1908 R74657 Davis Trent Wilkins II Active 07/01/2017 06/30/2018

1908 R75751 Dawit Sara Active 07/01/2017 06/30/2018

1908 R74095 Drake Chelsea Jo Active 07/01/2016 06/30/2017

1908 R74067 Drotar Persida Sarona Active 07/01/2017 06/30/2018

1908 R74920 Duong Joseph Thanh-Phu Active 07/01/2017 06/30/2018

1908 R74922 Dutt Mohan Active 07/01/2016 06/30/2017

1908 R75514 Eells Madeline Elizabeth Active 07/01/2017 06/30/2018

1908 R75516 Elsenheimer Kaitlin Nelson... Active 07/01/2017 06/30/2018

1908 R74659 Fayard Daniel Marcel Active 07/01/2017 06/30/2018

1908 R75004 Fegale Stephanie Laroche Active 07/01/2017 06/30/2018

1908 R73543 Ferraro Christina Renee Active 07/01/2016 06/30/2017

1908 R75557 Fetten Katharina Active 07/01/2017 06/30/2018

1908 R75517 Firouzi Kameren Reza Active 07/01/2017 06/30/2018

1908 R74927 Fletcher Amanda Whitleigh Active 07/01/2017 06/30/2018

1908 R74590 Flicek Kristina Therese Active 07/01/2017 06/30/2018

1908 R75758 Flores Bruno Cesar Active 07/01/2016 06/30/2017

1908 R74147 Franke Ryan Gerald Active 07/01/2016 06/30/2017

1908 R74677 Gemma Vincent Anthony Active 07/01/2017 06/30/2018

1908 R74682 Gill Dapinderjit Singh Active 07/01/2016 06/30/2017

1908 R75766 Gill Navdeep Active 07/01/2016 06/30/2017

1908 R74684 Gnass Matias Ronaldo Active 07/01/2016 06/30/2017

1908 R74648 Godzik Jakub Active 07/01/2017 06/30/2018

1908 R73464 Goldsmit Samuel Kalb Active 07/01/2017 06/30/2018

1908 R74928 Griffin Kenneth Scott Active 07/01/2017 06/30/2018

1908 R72414 Gubbels Ashley Lynn Active 07/01/2017 06/30/2018

Page Number 15 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

St Joseph's Hospital and Medical Center 1908 R74666 Gutierrez James Joseph Active 07/01/2017 06/30/2018

1908 R73968 Habib Naomi Grace Active 07/01/2017 06/30/2018

1908 R74668 Hamed Moath A Active 07/01/2017 06/30/2018

1908 R74929 Hamilton Robert Sanford Active 07/01/2017 06/30/2018

1908 R72490 Hardesty Douglas Allen Active 07/01/2017 06/30/2018

1908 R74675 Harry Rishi Inder Singh Active 07/01/2017 06/30/2018

1908 R75458 Hashmi Syed Safiuddin Active 07/01/2016 06/30/2017

1908 R74651 Haverland Rachael Ann Active 07/01/2017 06/30/2018

1908 R74652 Hefley Erin Foster Active 07/01/2017 06/30/2018

1908 R75570 Hendricks Benjamin Kevin Active 07/01/2017 06/30/2018

1908 R72006 Hill David Anthony Active 03/26/2017 03/25/2018

1908 R73509 Hlubek Randall John Active 07/01/2017 06/30/2018

1908 R75490 Ho Timothy Kenneth Active 07/01/2017 06/30/2018

1908 R74155 Hopkins Gina Marie Active 07/01/2017 06/30/2018

1908 R74676 Hoshi Sami Active 07/01/2017 06/30/2018

1908 R75752 Hoskin Justin Lynn Active 07/01/2017 06/30/2018

1908 R74925 Hosten Blackmond Tiffany A... Active 07/01/2017 06/30/2018

1908 R74681 Huang Dih-dih Active 07/01/2017 06/30/2018

1908 R74873 Hudson Michael Lee Active 07/01/2016 06/30/2017

1908 R74665 Jackson Robert Julian Active 07/01/2017 06/30/2018

1908 R74672 Jacobsen Bill James Active 07/01/2017 06/30/2018

1908 R76085 Jagan Nikhil Active 05/01/2017 05/16/2017

1908 R75559 Jones Michael David Active 07/01/2017 06/30/2018

1908 R73602 Khanna Rohit Active 07/01/2016 06/30/2017

1908 R74654 Khosla Manraj Singh Active 07/01/2016 06/30/2017

1908 R73381 Kuwabara Michael Skarles Active 07/01/2016 06/30/2017

1908 R75406 Labib Mohamed Ahmed Maher Active 07/01/2017 06/30/2018

1908 R75493 Larsen Brett Robert Active 07/01/2016 06/30/2017

1908 R74690 Maggo Gunjan Active 07/01/2016 06/30/2017

1908 R74680 Matthees Nicholas Garrity Active 07/01/2017 06/30/2018

1908 R74066 McClure Kelsey Elizabeth Active 07/01/2017 06/30/2018

1908 R74074 McCourt Jason Michael Active 07/01/2017 06/30/2018

Page Number 16 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

St Joseph's Hospital and Medical Center 1908 R74655 Mehandru Natasha Active 07/01/2017 06/30/2018

1908 R72007 Mirzadeh Zaman Zacharya Active 07/01/2016 06/30/2017

1908 R75485 Misra Suman Susant Active 07/01/2017 06/30/2018

1908 R74678 Mistrot Daniel Paul Active 07/01/2017 06/30/2018

1908 R74667 Mony Shruti Sukumar Active 07/01/2017 06/30/2018

1908 R72004 Moon Karam Active 07/01/2016 06/30/2017

1908 R74142 Mooney Michael Anthony Active 07/01/2017 06/30/2018

1908 R75569 Morgan Clinton David Active 07/01/2017 06/30/2018

1908 R73519 Mulholland Celene Bardales... Active 07/01/2017 06/30/2018

1908 R75765 Munshi Aarohi Hiren Active 07/01/2017 06/30/2018

1908 R74663 Murthy Ganesh Raghava Active 07/01/2017 06/30/2018

1908 R75520 Nadella Samantha Paturu Active 07/01/2016 06/30/2017

1908 R72721 Nalagan Justin Andre Active 07/01/2017 06/30/2018

1908 R75488 Nallagangula Aparna Active 07/01/2017 06/30/2018

1908 R72595 Nanaszko Michael Joseph Active 07/01/2017 06/30/2018

1908 R74139 Nwojo Macaulay Ezera Active 07/01/2017 06/30/2018

1908 R75433 Osho Ayokunle Tolulope Active 07/01/2017 06/30/2018

1908 R74656 Pahuja Mohit Active 07/01/2016 06/30/2017

1908 R74093 Patel Bindu Naranbhai Active 07/01/2016 06/30/2017

1908 R74926 Patel Shyam Active 07/01/2017 06/30/2018

1908 R75008 Pham An Thien Active 07/01/2017 06/30/2018

1908 R75428 Plasto Dinko Active 07/01/2017 06/30/2018

1908 R73518 Powell Travis Joseph Active 07/01/2016 06/30/2017

1908 R75005 Powers Kathleen Ann Active 07/01/2017 06/30/2018

1908 R74879 Przybylowski Colin John Active 07/01/2017 06/30/2018

1908 R75518 Reise Kathryn Helena Active 07/01/2017 06/30/2018

1908 R75010 Ritz Lauren Christine Active 07/01/2017 06/30/2018

1908 R74664 Robers Michael Vincent Active 07/01/2017 06/30/2018

1908 R75753 Root Shane Marcus Active 07/01/2017 06/30/2018

1908 R75487 Ross Mitchell David Active 07/01/2017 06/30/2018

1908 R75459 Roura Daniel Active 07/01/2017 06/30/2018

1908 R75215 Rubalcava Nathaniel Scott Active 07/01/2017 06/30/2018

Page Number 17 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

St Joseph's Hospital and Medical Center 1908 R74653 Rzepka Alexandra Josephine... Active 07/01/2017 06/30/2018

1908 R75009 Saadoun Basma Mamdouh Active 07/01/2017 06/30/2018

1908 R74661 Sahgal Alok Krishna Active 07/01/2016 06/30/2017

1908 R74918 Sanford Jessica Lauren Active 07/01/2017 06/30/2018

1908 R74880 Sarris Christina Elizabeth... Active 07/01/2017 06/30/2018

1908 R72638 Scharnweber Travis Steven Active 07/01/2016 06/30/2017

1908 R75895 See Pok-meng Active 07/01/2017 06/30/2018

1908 R74080 Serrone Rosemarie Orene Active 07/01/2017 06/30/2018

1908 R75461 Sfondouris John Lewis Active 07/01/2016 06/30/2017

1908 R74688 Shah Akash Active 07/01/2016 06/30/2017

1908 R75720 Shah Paarth Janak Active 07/01/2017 06/30/2018

1908 R75002 Sharif Momamed Fatima Aba Active 07/01/2017 06/30/2018

1908 R74091 Sheehy John Paul Active 07/01/2017 06/30/2018

1908 R75553 Shetty Rashna Active 07/01/2017 06/30/2018

1908 R75486 Singh Nisha Mei Active 07/01/2016 06/30/2017

1908 R73362 Steenerson Kristen Kay Active 07/01/2016 06/30/2017

1908 R75565 Stenquist Justin Jay Active 07/01/2017 06/30/2018

1908 R75457 Stone Michael Eric Active 07/01/2016 06/30/2017

1908 R75432 Stricof Jared Jacob Active 07/01/2017 06/30/2018

1908 R73524 Tan Cynthia Kay Khine Zaw Active 07/01/2016 06/30/2017

1908 R74683 Taylor Rachel Reinhart Active 07/01/2017 06/30/2018

1908 R74919 Thakrar Hiral Pradip Active 07/01/2017 06/30/2018

1908 R75568 Tholl Nathan Andrew Active 06/30/2017

1908 R75000 Usman Uzma Active 07/01/2017 06/30/2018

1908 R75764 Vajjala Vimala Sravanthi Active 07/01/2017 06/30/2018

1908 R75003 Vo Elise Halan Active 07/01/2017 06/30/2018

1908 R74649 Walker Corey Tyler Active 07/01/2017 06/30/2018

1908 R75754 Wang Liang Active 07/01/2017 06/30/2018

1908 R74923 Wang Tingrui Active 07/01/2017 06/30/2018

1908 R75491 Weed Michael David Active 07/01/2016 06/30/2017

1908 R75755 Weng Xiao Jun Active 07/01/2017 06/30/2018

1908 R74646 Whiting Alexander Charles Active 07/01/2017 06/30/2018

Page Number 18 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

St Joseph's Hospital and Medical Center 1908 R72485 Wright Ernest John III Active 07/01/2017 06/30/2018

1908 R73471 Xu David Shuo Active 07/01/2017 06/30/2018

1908 R75426 Yerasi Charan Teja Reddy Active 07/01/2017 06/30/2018

1908 R74930 Yuen Steven Active 07/01/2017 06/30/2018

1908 R74998 Yum Alma Sook Active 07/01/2016 06/30/2017

1908 R72001 Zaidi Hasan Aqdas Active 07/01/2016 06/30/2017

1908 R74662 Zhang Roy Xiao Active 07/01/2017 06/30/2018

1908 R74669 Zigelbaum Aaron Active 07/01/2017 06/30/2018

Tucson Hospitals Medical Education 1908 R75689 Atkinson Gregory Esplin Active 07/01/2016 06/30/2017

1908 R75691 Farnworth Michael Todd Active 07/01/2016 06/30/2017

1908 R75692 Gurney Antonia Marie Active 07/01/2016 06/30/2017

1908 R75693 Heringer Diana Leigh Active 07/01/2016 06/30/2017

1908 R75694 Lester Lucy Cheng Active 07/01/2016 06/30/2017

1908 R75695 Miller Emily Kristine Active 07/01/2016 06/30/2017

1908 R75697 Rayikanti Benjamin Abhishe... Active 07/01/2016 06/30/2017

1908 R75700 Thomas Christopher George Active 07/01/2016 06/30/2017

1908 R75690 Thorup Datus Brock Active 07/01/2016 06/30/2017

University of Arizona 1908 R74160 Abdelaziz Amr Samy Mohame Active 07/01/2017 07/27/2017

1908 R73826 Aboul-Nasr Khalid Gamal Active 07/01/2016 06/30/2017

1908 R73429 Abu Zaid Laila Issam Taher... Active 07/01/2016 06/30/2017

1908 R73869 Acevedo Echevarria Fidel A... Active 07/01/2016 06/30/2017

1908 R75449 Adams Thomas Allan Active 07/01/2016 06/30/2017

1908 R76069 Addams Joel Active 07/01/2017 06/30/2018

1908 R76098 Adel Eugene Active 07/01/2017 06/30/2018

1908 R74562 Agarwal Daniel Rahul Active 07/01/2016 06/30/2017

1908 R75504 Aggarwal Avin Active 07/01/2017 06/30/2018

1908 R72679 Ahmad Kareem Irshad Shaikh.. Active 07/01/2016 06/30/2017

1908 R74338 Ahmed Bashar Khandaker Active 07/01/2017 06/30/2018

1908 R76118 Ahmed Iman Mohamoud Active 07/01/2017 06/30/2018

1908 R76093 Ahrendt Nicholas R Active 07/01/2017 06/30/2018

1908 R74534 Akazawa Stacy Hinako Active 07/01/2016 06/30/2017

1908 R75471 Al Bayati Shahad Shamel Ib... Active 07/01/2016 06/30/2017

Page Number 19 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R72935 Al-Salman Khalil Active 09/01/2016 06/30/2017

1908 R74693 Alam Payam Active 07/01/2017 06/30/2018

1908 R75032 Alden Michelle Lynn Active 07/01/2017 06/30/2018

1908 R74462 Alexander Christina Elizab... Active 07/01/2016 06/30/2017

1908 R75572 Ali Hasan Akram Active 07/01/2017 06/30/2018

1908 R75463 Ali Zeina Abdulla Active 07/01/2017 06/30/2018

1908 R76072 Alizadeh Reza Active 07/01/2017 06/30/2018

1908 R74603 Alkatib Rhonda Emily Active 07/01/2017 06/30/2018

1908 R73830 Alobaidi Fahad Active 07/01/2017 06/30/2018

1908 R75725 Alrabia Ealaf Ahmed Active 07/01/2016 06/30/2017

1908 R75462 Altisheh Roula Active 07/01/2017 06/30/2018

1908 R75702 Amaraneni Akshay Active 07/01/2016 06/30/2017

1908 R75030 Amberger Mimi Z Active 07/01/2017 06/30/2018

1908 R76077 Amire-brahimi Benjamin A Active 07/01/2017 06/30/2018

1908 R74560 Anderson Jason Thomas Active 07/01/2017 06/30/2018

1908 R76110 Angus Christopher R Active 07/01/2017 06/30/2018

1908 R75597 Anvar Elhaam Active 07/01/2017 06/30/2018

1908 R74909 Aquino Alian Active 07/01/2017 06/30/2018

1908 R74385 Aranas Jennifer Leigh Active 07/01/2017 06/30/2018

1908 R74021 Arnold Stacy Jean Active 07/01/2016 06/30/2017

1908 R73219 Askam Brad Michael Active 07/01/2016 06/30/2017

1908 R75425 Asseri Ali Mohammed Active 04/11/2017 04/10/2018

1908 R72856 Ateeli Huthayfa Afif Active 07/01/2017 06/30/2018

1908 R74605 August Jessica Ann Active 07/01/2017 06/30/2018

1908 R75667 Avila Guerra Mauricio Jose... Active 07/01/2017 06/30/2018

1908 R74017 Aziz Hassan Active 07/01/2017 06/30/2018

1908 R75443 Bach Mimi Sabrine Henia Active 07/01/2017 06/30/2018

1908 R74520 Baig Muhammad Usman Akbar Active 07/01/2016 06/30/2017

1908 R76028 Bailey Morgan E Active 07/01/2017 06/30/2018

1908 R74531 Bailey Omavi Folu Active 07/01/2017 06/30/2018

1908 R74502 Bajaj Aung K Active 07/01/2016 06/30/2017

1908 R74936 Baker Zachary Paul Active 07/01/2016 06/30/2017

Page Number 20 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R75076 Baksh Aureen Reza Active 07/01/2017 06/30/2018

1908 R75465 Balogun Rilwan Abiola Active 07/01/2017 06/30/2018

1908 R75526 Bang Sung-wook Jesse Active 07/01/2017 06/30/2018

1908 R75534 Barbee Bonnie Jane Active 07/01/2017 06/30/2018

1908 R76064 Barber Samuel R Active 07/01/2017 06/30/2018

1908 R75663 Barcelo Bianca Elena Active 07/01/2017 06/30/2018

1908 R75198 Barnett Kelly Active 07/01/2017 06/30/2018

1908 R74450 Barrett Kristen Marie Active 07/01/2016 06/30/2017

1908 R74341 Barry Jonnae Yvonne Active 07/01/2017 06/30/2018

1908 R76169 Barth Talmage H Active 07/01/2017 06/30/2018

1908 R74482 Bartholomew Ashley Elizabe... Active 07/01/2016 06/30/2017

1908 R73956 Bartz Marisa Angeline Active 07/01/2016 06/30/2017

1908 R73832 Baumann Jessica Leigh Active 07/01/2016 06/30/2017

1908 R75669 Bayze Brian Edward Active 07/01/2017 06/30/2018

1908 R74607 Beatty Norman Laurence Active 07/01/2017 06/30/2018

1908 R74608 Bechtold Lance Lee Active 07/01/2017 06/30/2018

1908 R75017 Beck Emily Nicole Active 07/01/2017 06/30/2018

1908 R74945 Bell Robert Christopher Active 07/01/2017 06/30/2018

1908 R76031 Bellacose Carmel S Active 07/01/2017 06/30/2018

1908 R76014 Bendall William B Active 07/01/2017 06/30/2018

1908 R76119 Benson Darik S Active 07/01/2017 06/30/2018

1908 R75723 Benton Lauren Deanna Active 07/01/2017 06/30/2018

1908 R74109 Bentz David Daniel Active 07/01/2016 06/30/2017

1908 R74933 Bergersen Andrew Michael Active 07/01/2017 06/30/2018

1908 R74893 Berlinberg Adam Justin Active 07/01/2017 06/30/2018

1908 R74934 Bernardi Mark Thomas Active 07/01/2017 06/30/2018

1908 R75672 Bertoch Spencer Todd Active 07/01/2017 06/30/2018

1908 R74962 Betancourt Robert Anthony ... Active 07/01/2017 06/30/2018

1908 R75589 Bethel Aubrey Anne Active 07/01/2017 06/30/2018

1908 R74165 Bhargava Rishi Kumar Active 07/01/2016 06/30/2017

1908 R76094 Bhatia Shanti C Active 07/01/2017 06/30/2018

1908 R74455 Bhowra Amarpreet Singh Active 07/01/2017 06/30/2018

Page Number 21 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R74633 Bilal Jawad Active 07/01/2017 06/30/2018

1908 R74045 Bina Robert Wagner Active 06/24/2017 06/23/2018

1908 R75707 Binks Joshua Thomas Active 07/01/2017 06/30/2018

1908 R72752 Bisla Jaspreet Kaur Active 07/01/2016 06/30/2017

1908 R74638 Bitow Naomi Active 07/01/2016 06/30/2017

1908 R74994 Bixby Billie Ann Active 07/01/2017 06/30/2018

1908 R76046 Borg Bryan A Active 07/01/2017 06/30/2018

1908 R76142 Borra Nikhil R Active 07/01/2017 06/30/2018

1908 R76038 Bouzigard Rory M Active 07/01/2017 06/30/2018

1908 R76037 Boyer Preston J Active 07/01/2017 06/30/2018

1908 R74884 Brasiliense Leonardo Bruno... Active 07/01/2017 06/30/2018

1908 R75573 Breeding Breanna Cherie Active 07/01/2017 06/30/2018

1908 R76035 Breen Kevin T Active 07/01/2017 06/30/2018

1908 R74342 Brooling John Thomas Active 07/01/2016 06/30/2017

1908 R74900 Buckley Ryan Donald Active 07/01/2017 06/30/2018

1908 R75510 Buff Michelle Ann Active 07/01/2017 06/30/2018

1908 R75539 Burke Patrick Rian Active 07/01/2017 06/30/2018

1908 R76002 Bybee-driscoll Shannon J Active 07/01/2017 06/30/2018

1908 R74111 Byreddy Seenaiah Active 07/01/2017 06/30/2018

1908 R76003 Cain Cooper D Active 07/01/2017 06/30/2018

1908 R75435 Cannon Alexis Michelle Active 07/01/2017 06/30/2018

1908 R75537 Caraveo Marshall Aaron Active 07/01/2017 06/30/2018

1908 R74386 Cardenas - Trowers Olivia ... Active 07/01/2017 06/30/2018

1908 R74537 Carey John Joseph Active 07/01/2017 06/30/2018

1908 R76063 Carr Joseph L Active 07/01/2017 06/30/2018

1908 R76052 Carr Marcus P Active 07/01/2017 06/30/2018

1908 R74343 Carrasco Androuw Active 07/01/2016 06/30/2017

1908 R75496 Cartagena De Jesus Carla M... Active 07/01/2017 06/30/2018

1908 R74985 Cerruti Marc Anthony Active 07/01/2017 06/30/2018

1908 R76121 Champion Connor M Active 07/01/2017 06/30/2018

1908 R75511 Chan Christine Emi Active 07/01/2017 06/30/2018

1908 R74347 Chan Helen Active 07/01/2016 06/30/2017

Page Number 22 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R74346 Chan On Yee Active 07/01/2016 06/30/2017

1908 R76004 Chang Michelle E Active 07/01/2017 06/30/2018

1908 R74348 Chao Joseph T. Active 07/01/2017 06/30/2018

1908 R75724 Charles Rachael Ann Active 07/01/2017 06/30/2018

1908 R75450 Chaus Fahad Mohammedamin Active 07/01/2017 06/30/2018

1908 R74474 Chen Hao Active 07/01/2016 06/30/2017

1908 R76066 Chen Winsor P Active 07/01/2017 06/30/2018

1908 R75590 Chesley Andrew Vernon Active 07/01/2016 06/30/2017

1908 R74911 Chiacchio Stephany Active 07/01/2017 06/30/2018

1908 R75498 Chiapaikeo David Active 07/01/2017 06/30/2018

1908 R74961 Chikwava Gwinyai Active 07/01/2017 06/30/2018

1908 R75894 Chinyadza Mandinanisa Active 07/01/2017 06/30/2018

1908 R75604 Chokr Jad Active 07/01/2016 06/30/2017

1908 R76025 Chopde Rakesh N Active 07/01/2017 06/30/2018

1908 R74143 Choudhary Gagandeep Active 07/01/2016 06/30/2017

1908 R73836 Choudhury Nabajit Active 07/01/2017 06/30/2018

1908 R73837 Chyatte David Anthony Active 07/01/2017 06/30/2018

1908 R76005 Clark Devin W Active 07/01/2017 06/30/2018

1908 R74984 Clendenen Jordan Christoph... Active 07/01/2017 06/30/2018

1908 R75538 Coffman Nathan Eugene Active 07/01/2017 06/30/2018

1908 R76171 Cole Denzel A Active 07/01/2017 06/30/2018

1908 R74344 Cosentino Anna-Marie Active 07/01/2017 06/30/2018

1908 R75272 Cotton Colleen Helen Active 07/13/2016 07/12/2017

1908 R75574 Cox Aneela Active 07/01/2017 06/30/2018

1908 R75575 Cox Joshua Keegan Active 07/01/2017 06/30/2018

1908 R74986 Craig Miguel Antonio Active 07/01/2017 06/30/2018

1908 R74053 Cramer Natan Morash Active 07/01/2016 06/30/2017

1908 R74944 Cristan Elaine Ann Active 07/01/2017 06/30/2018

1908 R75525 Dacey Michael Joseph Active 07/01/2017 06/30/2018

1908 R75484 Dahip Michael Satkyes Active 07/01/2017 06/30/2018

1908 R75958 Daley Sarah Keiko Active 01/01/2017 12/31/2017

1908 R74349 Damian Joshua Ruben Active 07/01/2017 06/30/2018

Page Number 23 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R74387 Dardis Danielle Rose Active 07/01/2017 06/30/2018

1908 R76015 Dare Reese M Active 07/01/2017 06/30/2018

1908 R75031 Das Anindita Active 07/01/2017 06/30/2018

1908 R75470 Davidson Evan Nathaniel Active 07/01/2016 06/30/2017

1908 R74115 Davila Belen Active 07/01/2016 06/30/2017

1908 R76044 Davoodi Auva Active 07/01/2017 06/30/2018

1908 R73980 Davuluri Rajayogesh Active 07/01/2016 06/30/2017

1908 R75121 Dawod Judy Active 07/01/2017 06/30/2018

1908 R73840 Day Kevin Active 07/01/2016 06/30/2017

1908 R75756 Demant Martin Thomas Active 07/01/2017 06/30/2018

1908 R74351 Desai Hem Hemantbhai Active 07/01/2016 06/30/2017

1908 R76000 Dhakal Bishnu Prasad Active 07/01/2017 06/30/2018

1908 R76065 Dicken John M Active 07/01/2017 06/30/2018

1908 R74480 Dill James Joseph II Active 07/01/2017 06/30/2018

1908 R75442 Dinovitz Matthew Scott Active 07/01/2017 06/30/2018

1908 R74983 Divittorio Sarah Emily Active 07/01/2017 06/30/2018

1908 R76078 Djabiras Christina Active 07/01/2017 06/30/2018

1908 R74561 Dong Yimin Active 07/01/2017 06/30/2018

1908 R74352 Douglas Matthew Joseph K. Active 07/01/2016 06/30/2017

1908 R74559 Dowling Tyler Randolph Active 07/01/2017 06/30/2018

1908 R76061 Du Mont Christian M Active 07/01/2017 06/30/2018

1908 R76016 Dunne Katherine Active 07/01/2017 06/30/2018

1908 R75506 Durando Michael Luca Active 07/01/2017 06/30/2018

1908 R74960 Dyniewski Bradley Eugene Active 07/01/2017 06/30/2018

1908 R75053 Eales Justin Robert Active 07/01/2017 06/30/2018

1908 R75508 Eberson Sarah Nicole Active 07/01/2016 06/30/2017

1908 R75444 Effron Morgan Rebecca Active 07/01/2017 06/30/2018

1908 R76017 Effron Zachary A Active 07/01/2017 06/30/2018

1908 R72892 El Ramahi Razan Al Watheq ... Active 08/01/2016 07/31/2017

1908 R73685 El-Aini Ahmed Tammer Yehia.. Active 02/01/2017 01/31/2018

1908 R73235 Ellingson Clifford Christi... Active 07/01/2016 06/30/2017

1908 R76047 Elliott Charles W Active 07/01/2017 06/30/2018

Page Number 24 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R74353 Elrokhsi Salaheddin H. I. ... Active 07/01/2017 07/12/2017

1908 R75455 Enriquez Nicolas Antonio Active 07/01/2017 06/30/2018

1908 R75317 Erisman Matthew Saxon Active 07/01/2017 06/30/2018

1908 R75811 Eshghi Naghmehossadat Active 07/01/2017 06/30/2018

1908 R74391 Esparza Melissa Active 07/01/2017 06/30/2018

1908 R75890 Estep Lauren Elizabeth Active 07/01/2017 06/30/2018

1908 R75551 Etter Micah Active 07/01/2017 06/30/2018

1908 R76092 Eubank Louis R Active 07/01/2017 06/30/2018

1908 R73775 Evans-Lomayesva Rowan Active 07/01/2016 06/30/2017

1908 R74533 Faheem Urooba Active 07/01/2017 06/30/2018

1908 R75576 Falgout David Matthew Active 07/01/2017 06/30/2018

1908 R75596 Familtsev Dmitry Active 07/01/2017 06/30/2018

1908 R74963 Famoso Justin Michael Active 07/01/2017 06/30/2018

1908 R76036 Fan Heinrich D Active 07/01/2017 06/30/2018

1908 R74993 Farshad Kayven Max Active 07/01/2017 06/30/2018

1908 R72569 Faucett Erynne Azalea Active 07/01/2016 06/30/2017

1908 R74536 Fauq Irfan Kibrya Active 07/01/2017 06/30/2018

1908 R73842 Ferguson Jeannette Elizabe... Active 07/01/2016 06/30/2017

1908 R75503 Field Adam Michael Active 07/01/2017 06/30/2018

1908 R74394 Figueroa Javier Jose Active 07/01/2016 06/30/2017

1908 R74896 Finkelshteyn Ilya Active 07/01/2017 06/30/2018

1908 R74966 Fletcher Peter Joseph Active 07/01/2017 06/30/2018

1908 R74970 Ford Sydne Danielle Active 07/01/2017 06/30/2018

1908 R76041 Forrestel Andrew C Active 07/01/2017 06/30/2018

1908 R76034 Foshee James P Active 07/01/2017 06/30/2018

1908 R74388 Fotouhie Azadeh Farah Active 07/01/2017 06/30/2018

1908 R73964 Fox Alexandra Nicole Active 07/01/2016 06/30/2017

1908 R74057 Fox James David Active 07/01/2017 06/30/2018

1908 R75536 Fraivillig Kurt Leonard Active 07/01/2016 06/30/2017

1908 R73925 Franke Kimberly Jo Active 07/01/2017 06/30/2018

1908 R74354 Gadd Crystal Lorraine Active 07/01/2017 06/30/2018

1908 R75473 Gadzik Erica Smith Active 07/01/2017 06/30/2018

Page Number 25 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R74988 Gaefke Claudia Lucia Active 07/01/2017 06/30/2018

1908 R75070 Gamez Justin Michael Active 07/01/2017 06/30/2018

1908 R75500 Ganddini-wagner Gabriela M... Active 07/01/2017 06/30/2018

1908 R75507 Gangar Pamela Active 07/01/2017 06/30/2018

1908 R76042 Garcia Ariel E Active 07/01/2017 06/30/2018

1908 R74899 Garcia Mary Carmen Active 07/01/2017 06/30/2018

1908 R76101 Gardner Gregory P Active 07/01/2017 06/30/2018

1908 R75441 Garren Madeleine Valerie Active 07/01/2016 06/30/2017

1908 R74952 Garrison David Jeremiah Active 07/01/2017 06/30/2018

1908 R73241 Garza Hyon-he Kim Active 07/01/2017 06/30/2018

1908 R74473 Garza Joshua Isaac Active 07/01/2017 06/30/2018

1908 R76062 Gaskin Gregory L Active 07/01/2017 06/30/2018

1908 R76048 Gaul Corey J Active 07/01/2017 06/30/2018

1908 R74355 Gaynor Pryce Tiffany Active 07/01/2016 06/30/2017

1908 R73242 Geffre Christopher Paul Active 07/01/2016 06/30/2017

1908 R74558 Gelman Rachel Ann Active 07/01/2016 06/30/2017

1908 R75135 Ghani Sadia Begum Active 07/01/2017 06/30/2018

1908 R74031 Ghazala Laith Active 07/01/2016 06/30/2017

1908 R74969 Ghazala Sehem Active 07/01/2017 06/30/2018

1908 R73844 Ghosh Romy Active 07/01/2016 06/30/2017

1908 R75588 Glasser Joshua Anders Active 07/01/2017 06/30/2018

1908 R76086 Glazer Alex M Active 07/01/2017 06/30/2018

1908 R74750 Glotser Phillip L Active 07/01/2017 06/30/2018

1908 R74889 Goel Khushboo Active 07/01/2017 06/30/2018

1908 R76079 Golconda Umamaheshwari Active 07/01/2017 06/30/2018

1908 R76097 Goldberg Daniel Active 07/01/2017 06/30/2018

1908 R74392 Gomez Selpides Aurora Alej... Active 07/01/2016 06/30/2017

1908 R75013 Gonsalves Steven Wesley Al... Active 07/01/2017 06/30/2018

1908 R74554 Gonzales Christopher Josep... Active 07/01/2017 06/30/2018

1908 R73243 Gonzalez Maritza Grisselle... Active 07/01/2017 06/30/2018

1908 R75582 Gosey Gregory Maxwell Active 07/01/2017 06/30/2018

1908 R73846 Goyal Uma Devi Active 07/01/2016 06/30/2017

Page Number 26 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R75466 Graetz Riley Michael Active 07/01/2017 06/30/2018

1908 R75066 Green Tiffany Hyman Active 07/01/2017 06/30/2018

1908 R73886 Greenfield Lisa Marie Active 07/01/2016 06/30/2017

1908 R75532 Grigsby Brianna Michelle Active 07/01/2017 06/30/2018

1908 R74908 Grin Boris Active 07/01/2017 06/30/2018

1908 R73887 Grotepas Cassi Brielle Active 07/01/2016 06/30/2017

1908 R76059 Guyton Kevin P Active 07/01/2017 06/30/2018

1908 R74579 Habibi Pasdar Seyed Sohail... Active 07/01/2017 08/31/2017

1908 R74481 Hadeed George James Active 07/01/2016 06/30/2017

1908 R75074 Hagenberg Robert John Active 07/01/2017 06/30/2018

1908 R75445 Halasa Rachelle Megan Active 07/01/2017 06/30/2018

1908 R75767 Han James Edward Active 07/01/2017 06/30/2018

1908 R74117 Hansen Eric T Active 07/01/2016 06/30/2017

1908 R75067 Hansra Haramrit Singh Active 07/01/2017 06/30/2018

1908 R75583 Hanzlik Thomas Pinkas Active 07/01/2017 06/30/2018

1908 R75593 Harhash Ahmed Active 07/01/2017 06/30/2018

1908 R75726 Harkins Ryan Michael Active 07/01/2017 06/30/2018

1908 R75048 Harms Christopher Thomas Active 07/01/2016 06/30/2017

1908 R76022 Harris Nathaniel A Active 07/01/2017 06/30/2018

1908 R74357 Hartenstein Parvana Amelia... Active 07/01/2016 06/30/2017

1908 R75467 Hartl Katherine Nicole Active 07/01/2017 06/30/2018

1908 R75075 Hassan Zaynb Abdul Aziz Active 07/01/2016 06/30/2017

1908 R75061 Havens Tara Nicole Active 07/01/2017 06/30/2018

1908 R73890 Hawke Abigail Sefert Active 07/01/2016 06/30/2017

1908 R75603 Helmrick-blossom Jessin Active 07/01/2017 06/30/2018

1908 R74459 Henderson Joseph Van Somer. Active 07/01/2016 06/30/2017

1908 R75705 Henglefelt Steven Ross Active 07/01/2017 06/30/2018

1908 R75092 Hennigan Andrew William Active 07/01/2017 06/30/2018

1908 R75302 Hernandez Leslie Ann Active 07/01/2017 06/30/2018

1908 R74940 Hernandez Zachary James Active 07/01/2017 06/30/2018

1908 R75521 Heyn Andrea Naomi Active 07/01/2017 06/30/2018

1908 R75446 Higham-kessler Richard Aug... Active 07/01/2017 06/30/2018

Page Number 27 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R75585 Hill Michael Cary Active 07/01/2017 06/30/2018

1908 R76060 Hinkel Cameron J Active 07/01/2017 06/30/2018

1908 R75548 Ho Cathy Vu Active 08/01/2017 07/31/2018

1908 R74894 Ho Hang Thi Thuy Active 07/01/2017 06/30/2018

1908 R73891 Hoang Brian Hai Active 07/01/2017 06/30/2018

1908 R74895 Hodgdon Kathryn Ellen Active 07/01/2017 06/30/2018

1908 R74360 Hollinger Jennifer Christi... Active 07/01/2016 06/30/2017

1908 R76141 Holloway Amanda R Active 07/01/2017 06/30/2018

1908 R76112 Hothi Samandip S Active 07/01/2017 06/30/2018

1908 R74359 Houmes Stephen Wayne Active 07/01/2016 06/30/2017

1908 R74897 Howard Ryan Hood Active 07/01/2017 06/30/2018

1908 R75023 Hu Amy Yawen Active 07/01/2017 06/30/2018

1908 R73257 Huang Christine Alicia Active 07/01/2016 06/30/2017

1908 R74954 Huynh Dang Hai Active 07/01/2017 06/30/2018

1908 R74973 Huynh Jacqueline Ngoc Active 07/01/2017 06/30/2018

1908 R75594 Ibarra Alejandro Active 07/01/2017 06/30/2018

1908 R74990 Imbornoni Lauren Marie Active 07/01/2017 06/30/2018

1908 R75600 Insel Michael Active 07/01/2017 06/30/2018

1908 R74479 Ishii Jon Seizen Active 07/01/2016 06/30/2017

1908 R74613 Jaffer Faraz Active 07/01/2017 06/30/2018

1908 R72770 Jahan Kahroba Active 07/01/2016 06/30/2017

1908 R76170 Janajreh Yousef M Active 07/01/2017 06/30/2018

1908 R74361 Jarczyk John Paul Active 07/01/2016 06/30/2017

1908 R75577 Jarman Joshua Paul Active 07/01/2016 06/30/2017

1908 R74898 Jarrett II Benjamin Jay Active 07/01/2017 06/30/2018

1908 R76039 Jean Joshua Active 07/01/2017 06/30/2018

1908 R73897 Jhajj Sandeep Singh Active 07/01/2017 06/30/2018

1908 R75595 Johnson Christopher Brian Active 07/01/2017 06/30/2018

1908 R75535 Johnson Drew Carter Active 07/01/2017 06/30/2018

1908 R74396 Jones Trahern Wallace Active 07/01/2017 06/30/2018

1908 R73261 Jordan Sean Alexander Active 07/01/2016 06/30/2017

1908 R76054 Joseph Robin A Active 07/01/2017 06/30/2018

Page Number 28 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R74179 Jule Alexander Wesley Active 07/01/2016 06/30/2017

1908 R75448 Junna Shilpa Active 07/01/2017 06/30/2018

1908 R74156 Kandala Jagdesh Active 07/01/2016 06/30/2017

1908 R74645 Kantamneni Sowmya Active 07/01/2016 06/30/2017

1908 R74946 Kasch Anthony Robert Active 07/01/2017 06/30/2018

1908 R74023 Keblesh James Patrick Active 07/01/2016 06/30/2017

1908 R74964 Kellis Nathan Ammon Active 07/01/2017 06/30/2018

1908 R75527 Kelly Sean Christopher Active 07/01/2016 06/30/2017

1908 R74916 Kemmerly Thomas Michael Active 07/01/2017 06/30/2018

1908 R76045 Kempers Brian T Active 07/01/2017 06/30/2018

1908 R76006 Khan Abdul S Active 07/01/2017 06/30/2018

1908 R74981 Khan Jahanzeb Ali Active 07/01/2016 06/30/2017

1908 R74935 Khan Maria Mohammad Active 07/01/2017 06/30/2018

1908 R75398 Khattab Nasim Abdelhamid M.. Active 01/18/2017 01/17/2018

1908 R75494 Khwaja Ansab Mohammad Active 07/01/2017 06/30/2018

1908 R74979 Kim Candice Jinhee Active 07/01/2017 06/30/2018

1908 R76026 Kim David D Active 07/01/2017 06/30/2018

1908 R76018 Kim Jaehyun H Active 07/01/2017 06/30/2018

1908 R75578 Kim James D Active 07/01/2017 06/30/2018

1908 R75501 Kim Jeeyong Charlie Active 07/01/2017 06/30/2018

1908 R74362 Kim Sunchin Active 07/01/2017 06/30/2018

1908 R75477 King Skye Chance Active 07/01/2017 06/30/2018

1908 R73263 Kisat Mehreen Teizoon Active 07/01/2017 06/30/2018

1908 R74551 Kjellsson Kristine Blosk Active 07/01/2017 06/30/2018

1908 R74122 Koleilat Shadi Maher Active 07/01/2017 06/30/2018

1908 R73237 Kollampare Shubha Active 07/01/2016 06/30/2017

1908 R74363 Korovin Lev Nikolayevich Active 07/01/2017 06/30/2018

1908 R73264 Kovoor Andrew Iype Active 07/01/2017 06/30/2018

1908 R73900 Kraemer Codyjo Kenneth Active 07/01/2017 06/30/2018

1908 R75012 Krase Jeffrey Michael Active 07/01/2017 06/30/2018

1908 R76073 Kubba Saad Sabah Active 07/01/2017 06/30/2018

1908 R74581 Kulkarni Abhishek Active 07/01/2016 06/30/2017

Page Number 29 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R76007 Kumala Erica Active 07/01/2017 06/30/2018

1908 R74364 Kumar Abhijeet Active 07/01/2016 06/19/2017

1908 R74890 Kurland Yonatan Active 07/01/2017 06/30/2018

1908 R75709 Lakhanpal Aleena Active 07/01/2017 06/30/2018

1908 R76090 Landreth Hannah J Active 07/01/2017 06/30/2018

1908 R75475 Larkin Kevin Eugene Active 07/01/2017 06/30/2018

1908 R76056 Larsen Sean W Active 07/01/2017 06/30/2018

1908 R75041 Larson Michael Craig Active 07/01/2016 06/30/2017

1908 R75468 Laurion Victor Robert Active 07/01/2016 06/30/2017

1908 R76050 Lavi Jonathan R Active 07/01/2017 06/30/2018

1908 R75701 Lawrence Charles David Active 07/01/2017 06/30/2018

1908 R74452 Lawson Kevin Andrew Active 07/01/2017 06/30/2018

1908 R75502 Lecomte Matthew David Active 07/01/2017 06/30/2018

1908 R75512 Lectura Melissa Active 07/01/2017 06/30/2018

1908 R76043 Lee Ashton A Active 07/01/2017 06/30/2018

1908 R73267 Lee Elizabeth Soon Active 07/01/2016 06/30/2017

1908 R74365 Leitner Katherine Ann Active 07/01/2016 06/30/2017

1908 R75190 Lightfoot-Siordia Catrissa... Active 07/01/2017 06/30/2018

1908 R73976 Lin Frank C. Active 07/01/2017 06/30/2018

1908 R75483 Lisowski Mark James Active 07/01/2017 06/30/2018

1908 R75549 Liu Fangzhou Active 07/01/2017 06/30/2018

1908 R76020 Liu Xibei Active 07/01/2017 06/30/2018

1908 R75757 Logsdon Mary Anna Active 07/01/2017 06/30/2018

1908 R73479 Lokhandwala Adil Mohamadal.. Active 07/01/2017 06/30/2018

1908 R75552 Lopker Michael John Jr Active 07/01/2017 06/30/2018

1908 R75447 Low Sarah Ashley Active 07/01/2016 06/30/2017

1908 R74892 Low See Wei Active 07/01/2016 06/30/2017

1908 R74905 Lukefahr Ashley Leigh Active 07/01/2017 06/30/2018

1908 R75505 Lwin Aye Aung Active 07/01/2017 06/30/2018

1908 R76040 Lynn Bailey A Active 07/01/2017 06/30/2018

1908 R76080 Macaraeg Marci D Active 07/01/2017 06/30/2018

1908 R74173 Mackerricher Wendy Suzanne.. Active 07/01/2016 06/30/2017

Page Number 30 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R75042 Mackinnon Lea Marlys Active 07/01/2016 06/30/2017

1908 R75469 Maestas Travis Serafin Active 07/01/2017 06/30/2018

1908 R72212 Mahmoud Naser J M Active 07/01/2016 06/30/2017

1908 R76081 Mahoney William A Active 07/01/2017 06/30/2018

1908 R74958 Makoni John William Active 07/01/2017 06/30/2018

1908 R74980 Malburg Louise Cantisano Active 07/01/2017 06/30/2018

1908 R75043 Mann Dushyant Singh Active 07/01/2017 06/30/2018

1908 R76030 Manoharan Aditya Active 07/01/2017 06/30/2018

1908 R74174 Mansour Iyad S.M Active 07/01/2017 06/30/2018

1908 R76019 Manu Preeth N Active 07/01/2017 06/30/2018

1908 R74950 Manzo Rachel Lauren Active 07/01/2017 06/30/2018

1908 R75018 Marble Jorden Bryan Active 07/01/2017 06/30/2018

1908 R75452 Martin Adriana Adiana Theo... Active 07/01/2017 06/30/2018

1908 R74539 Martineau Katherine Suzann... Active 07/01/2016 06/30/2017

1908 R74389 Martinez Carolina Active 07/01/2017 06/30/2018

1908 R74465 Martinez Ryan Anthony Active 07/01/2017 08/11/2017

1908 R76145 Masood Hana S Active 07/01/2017 06/30/2018

1908 R73903 Mathew Prakash Joel Active 07/01/2017 06/30/2018

1908 R76067 McAllister Kevin J Active 07/01/2017 06/30/2018

1908 R73904 McCauley Taylor Suzette Active 07/01/2016 06/30/2017

1908 R75069 McCoppin Richard Francis Active 07/01/2017 06/30/2018

1908 R75662 McCusker Ashley Katherine Active 08/01/2017 07/31/2018

1908 R74157 McGlothin Travis Michael Active 07/01/2017 06/30/2018

1908 R73865 McGuire Katrina Nichole Active 07/01/2016 06/30/2017

1908 R74625 McLeod Whitney Webster Active 07/01/2016 06/30/2017

1908 R75472 Meadows Christopher Andrew.. Active 07/01/2017 06/30/2018

1908 R75666 Means Russell Reed Active 07/01/2017 06/30/2018

1908 R74012 Meek Cameron Alan Active 07/01/2017 08/11/2017

1908 R76158 Meiklejohn Karleen M Active 07/01/2017 06/30/2018

1908 R74578 Memeh Kelvin Onyeka Active 07/01/2017 06/30/2018

1908 R75509 Mereddy Suresh Reddy Active 07/01/2016 06/30/2017

1908 R73906 Mhayamaguru Kubwimana Mo Active 07/01/2016 06/30/2017

Page Number 31 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R72591 Michailidou Maria Active 07/01/2016 06/30/2017

1908 R73907 Michalak John Robert Active 07/01/2017 06/30/2018

1908 R73778 Miller Christopher Ryan Active 07/01/2016 06/30/2017

1908 R76082 Miller David C Active 07/01/2017 06/30/2018

1908 R74941 Miller Heather Lea Anne Active 07/01/2017 06/30/2018

1908 R76107 Miller Kristine M Active 07/01/2017 06/30/2018

1908 R74367 Milligan Rebecca Leigh Active 07/01/2017 06/30/2018

1908 R76001 Mitchell Kevin Ray Active 05/01/2017 05/29/2017

1908 R74907 Mitra Hari Shankar Active 07/01/2017 06/30/2018

1908 R72814 Mobily Matthew Edward Active 07/01/2017 06/30/2018

1908 R75528 Molina Andres Active 07/01/2017 06/30/2018

1908 R74913 Molligan Christopher Scott... Active 07/01/2017 06/30/2018

1908 R74369 Moosavi Rana Active 07/01/2017 06/30/2018

1908 R76166 Morgan Brittany L Active 07/01/2017 06/30/2018

1908 R74395 Morin Matthew Lamar Active 07/01/2017 06/30/2018

1908 R75579 Moritz Alison Paige Active 07/01/2017 06/30/2018

1908 R75696 Morrison Christopher Micha... Active 07/01/2017 06/30/2018

1908 R76167 Morrison Tiffany T Active 07/01/2017 06/30/2018

1908 R76008 Mortel Maria Dominique Jea... Active 07/01/2017 06/30/2018

1908 R75759 Mosadeghi Sasan Active 07/01/2017 06/30/2018

1908 R76051 Moseley Joseph R Active 07/01/2017 06/30/2018

1908 R75580 Mossadeghi Bijan Active 07/01/2017 06/30/2018

1908 R75189 Munroe Brent A Active 07/01/2017 06/30/2018

1908 R74368 Murphy Amanda Marie Active 07/01/2016 06/30/2017

1908 R75599 Murphy Kevin Gerard Jr. Active 07/01/2017 06/30/2018

1908 R75072 Murthy Maitreyi Active 07/01/2016 06/30/2017

1908 R75109 Mushtaq Raza Active 07/01/2017 06/30/2018

1908 R74397 Myer Kaley Alexandra Active 07/01/2016 06/30/2017

1908 R73490 Nanadiego Bernard Santos Active 07/01/2016 06/30/2017

1908 R75533 Nasser Keaton Mackenzie Active 07/01/2017 06/30/2018

1908 R74470 Navarro Tomas III Active 07/01/2016 06/30/2017

1908 R75104 Nealey Kathryn Ann Active 07/01/2017 06/30/2018

Page Number 32 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R75524 Neill Matthew Adam Active 07/01/2017 06/30/2018

1908 R75022 Nejad Andrew Ashkahn Active 07/01/2017 06/30/2018

1908 R74888 Nielsen Tyson James Active 07/01/2017 06/30/2018

1908 R75497 Nolte David Adam Active 07/01/2017 06/30/2018

1908 R75721 Norton Brian Christopher Active 07/01/2017 06/30/2018

1908 R76168 Nunes Cavalcante Parr Nadi... Active 07/01/2017 06/30/2018

1908 R74508 Nyotowidjojo Iwan Sugihart... Active 07/01/2017 06/30/2018

1908 R74982 Oats Samuel Holland Active 07/01/2016 06/30/2017

1908 R76089 Oesterle Colette M Active 07/01/2017 06/30/2018

1908 R75011 Okolo Onyemaechi Nwanneam Active 07/01/2017 06/30/2018

1908 R76099 Olds Gary S Active 07/01/2017 06/30/2018

1908 R76116 Oliver Brian T Active 07/01/2017 06/30/2018

1908 R72858 Omar Muna Danial Muneeb Active 07/01/2017 06/30/2018

1908 R74971 Omesiete Adejare Nkechinye... Active 07/01/2017 06/30/2018

1908 R73416 Onyishi Sylvester Ejiofor Active 07/01/2016 06/30/2017

1908 R76009 Ortega Gilbert D Active 07/01/2017 06/30/2018

1908 R75770 Osuchukwu Obiyo O Active 07/01/2017 06/30/2018

1908 R74615 Otis Justin Blake Active 07/01/2017 06/30/2018

1908 R75474 Otsuji Janelle Jk Active 07/01/2017 06/30/2018

1908 R74370 Oxley Christine Active 07/01/2016 06/30/2017

1908 R73916 Pace Brittany Lanee Active 07/01/2016 06/30/2017

1908 R72603 Palejwala Sheri Kirit Active 07/01/2016 06/30/2017

1908 R74885 Paliwal Aditya Active 07/01/2017 06/30/2018

1908 R75547 Pandey Abhishek Active 07/01/2016 06/30/2017

1908 R74373 Pandit Viraj Suresh Active 07/01/2017 06/30/2018

1908 R75522 Pantino David William Active 07/01/2017 06/30/2018

1908 R74471 Paradise Sara Rachel Active 07/01/2016 06/30/2017

1908 R73284 Park Soyoung Active 07/01/2017 06/30/2018

1908 R74570 Parsa Nour Alhoda Active 07/01/2016 06/30/2017

1908 R74097 Patel Karnika Vinod Active 07/01/2017 06/30/2018

1908 R73853 Patel Krushangi Shashikant... Active 07/01/2017 06/30/2018

1908 R74448 Patel Lance Kirit Active 07/01/2017 06/30/2018

Page Number 33 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R74617 Paul Derek Bryant Active 07/01/2017 06/30/2018

1908 R73285 Paulson Spencer Raye Active 07/01/2016 06/30/2017

1908 R75456 Peffley Sultana Keshwani Active 07/01/2017 06/30/2018

1908 R76027 Pereira Benedict R Active 07/01/2017 06/30/2018

1908 R74752 Perovic Marko Active 07/01/2017 06/30/2018

1908 R75711 Perovic Viktor Active 07/01/2016 06/30/2017

1908 R74977 Perrian Georgia Oana Active 07/01/2017 06/30/2018

1908 R74372 Pham Thu Ngoc Active 07/01/2017 06/30/2018

1908 R74454 Phung Michael Chang Active 07/01/2017 06/30/2018

1908 R74942 Pineda Jr Exequiel Timbol Active 07/01/2017 06/30/2018

1908 R76071 Pineda Miguel Active 07/01/2017 06/30/2018

1908 R74632 Placzek Elizabeth Jayne Active 07/01/2016 06/30/2017

1908 R75668 Platto Terry Nathaniel Active 07/01/2017 06/30/2018

1908 R75051 Pollard Courtney Kiersten Active 07/01/2017 06/30/2018

1908 R76100 Pollock Grant R Active 07/01/2017 06/30/2018

1908 R74996 Posch Michael Ian Active 07/01/2017 06/30/2018

1908 R75499 Powell David Bruce Active 07/01/2016 06/30/2017

1908 R75440 Pratt Landon Matthew Active 07/01/2017 06/30/2018

1908 R74463 Ramey Wyatt Langdon Active 07/01/2017 06/30/2018

1908 R74965 Rao Prashant Active 07/01/2017 06/30/2018

1908 R74464 Raub Rebecca Marie Active 07/01/2016 06/30/2017

1908 R74371 Rawani-Patel Priti Active 07/01/2017 06/30/2018

1908 R75454 Rawlins Rebecca Kathleen Active 07/01/2017 06/30/2018

1908 R75436 Recio Boiles Alejandro Active 07/01/2017 06/30/2018

1908 R74580 Reddick Ryan John David Active 07/01/2016 06/30/2017

1908 R74126 Reddy Sridhar M Active 07/01/2017 06/30/2018

1908 R76032 Reed Darien E Active 07/01/2017 06/30/2018

1908 R73291 Reghunathan Saranya Active 07/01/2017 06/30/2018

1908 R74937 Retterath Lindsey Marie Active 07/01/2017 06/30/2018

1908 R75033 Reveles Candace Yoshiko Active 07/01/2017 06/30/2018

1908 R74619 Revin Vladyslav Active 07/01/2017 06/30/2018

1908 R76010 Reyes Ruel J Active 07/01/2017 06/30/2018

Page Number 34 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R75437 Roberts Haydn John Active 07/01/2017 06/30/2018

1908 R75698 Robertson Jeffrey Mac Dona... Active 07/01/2017 06/30/2018

1908 R75451 Robertson Whitney Elizabet... Active 07/01/2017 06/30/2018

1908 R74959 Robinson Eric Andrew Active 07/01/2017 06/30/2018

1908 R76070 Rodriguez Juan Vitelio Active 07/01/2017 06/30/2018

1908 R73929 Roettges Paul Sebastian Active 07/01/2017 06/30/2018

1908 R76087 Rogers Amy R Active 07/01/2017 06/30/2018

1908 R75046 Rogers Samuel Neville Active 07/01/2016 06/30/2017

1908 R75086 Rozell Umbreem Arshad Active 07/01/2017 06/30/2018

1908 R72857 Rubio Napoleon Eduardo Cie... Active 07/01/2016 06/30/2017

1908 R76068 Rupakula Dinkar Active 07/01/2017 06/30/2018

1908 R76011 Russ Atlantis D Active 07/01/2017 06/30/2018

1908 R76102 Sabat Joseph E Active 07/01/2017 06/30/2018

1908 R73297 Sadoun Moutamn Active 07/01/2016 06/30/2017

1908 R73298 Safavi Arash Active 07/01/2016 06/30/2017

1908 R75719 Saha Sujata Active 07/01/2017 06/30/2018

1908 R74451 Sakai Yuki Active 07/01/2016 06/30/2017

1908 R74025 Sakla Sameh Adel Active 07/01/2017 06/30/2018

1908 R75476 Saligrama Phan Thai Active 07/01/2017 06/30/2018

1908 R76083 Salomone Scott M Active 07/01/2017 06/30/2018

1908 R75221 Sanchez Gisell Yuriana Active 07/01/2016 06/30/2017

1908 R74135 Sandhu Satinder Kaur Active 07/01/2017 06/30/2018

1908 R74957 Sandoval Linsey Anne Active 07/01/2017 06/30/2018

1908 R75222 Sandoval Miguel Isaiah Active 07/01/2017 06/30/2018

1908 R75068 Sandsmark Emilee Kingston ... Active 07/01/2017 06/30/2018

1908 R75200 Sargeant Jarred Jorge Just... Active 07/01/2017 06/30/2018

1908 R75529 Saunders Aaron Truitt Active 07/01/2017 06/30/2018

1908 R75264 Sawaya Jennifer Lynn Active 07/01/2017 06/30/2018

1908 R74891 Schatz George Henry Active 07/01/2017 06/30/2018

1908 R75699 Schryer Jane Sagnep Active 07/01/2017 06/30/2018

1908 R74158 Segar Jennifer Margaret Active 07/01/2017 06/30/2018

1908 R74538 Sekhon Kawanjit Kaur Active 07/01/2017 06/30/2018

Page Number 35 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R74503 Selpides Pocholo Jose Igna... Active 07/01/2016 06/30/2017

1908 R74556 Serrano - Rodriguez Jessic... Active 07/01/2017 06/30/2018

1908 R73301 Serrot Federico Jose Active 07/01/2016 06/30/2017

1908 R74447 Shah Aakash Shailesh Active 07/01/2017 06/30/2018

1908 R76120 Shah Ankit H Active 07/01/2017 06/30/2018

1908 R74565 Shah Halie Pankaj Active 07/01/2016 06/30/2017

1908 R75544 Shan Elaine Yining Active 07/01/2017 06/30/2018

1908 R74987 Shponka Volodymyr Active 07/01/2017 06/30/2018

1908 R75843 Shrensel Jeffrey Adam Active 07/01/2017 06/30/2018

1908 R75028 Sidhu Sukhampal Singh Active 07/01/2016 06/30/2017

1908 R75708 Sifuentes Joshua D Active 07/01/2017 06/30/2018

1908 R73938 Sim Yeeck Sung Active 07/01/2017 06/30/2018

1908 R75034 Simon Joseph Severo Active 07/01/2016 06/30/2017

1908 R74976 Singer Matthew Brian Active 07/01/2016 06/30/2017

1908 R74948 Singh Jasmine Active 07/01/2017 06/30/2018

1908 R75665 Singh Prabhjyot Active 07/01/2017 06/30/2018

1908 R74637 Singh Satinder Active 07/01/2016 06/30/2017

1908 R73940 Sinha Nisha Active 07/01/2017 06/30/2018

1908 R73781 Skrepnik Tijana Active 07/01/2017 06/30/2018

1908 R74129 Smith Brian Clark Active 07/01/2016 06/30/2017

1908 R74509 Smith Nicole Eleanor Active 07/01/2017 06/30/2018

1908 R75601 Snyder Shea Holden Active 07/01/2017 06/30/2018

1908 R75581 Sobowale Christopher Olaol... Active 07/01/2017 06/30/2018

1908 R75541 Solnicky Veronika Active 07/01/2017 06/30/2018

1908 R76055 Solola Sade A Active 07/01/2017 06/30/2018

1908 R75584 Son Tiffany Gihae Active 07/01/2017 06/30/2018

1908 R74056 Soni Nirali D Active 07/01/2017 06/30/2018

1908 R73782 Sowby James Blain Active 07/01/2017 06/30/2018

1908 R74131 Spice Jill Marie Active 07/01/2016 06/30/2017

1908 R74375 Spichler Moffarah Anne Active 07/01/2016 06/30/2017

1908 R76091 Spiker Jason A Active 07/01/2017 06/30/2018

1908 R74974 Srivastava Tarang Active 07/01/2017 06/30/2018

Page Number 36 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R76021 Starobinska Ella I Active 07/01/2017 06/30/2018

1908 R76049 Stavrakis Demetrios G Active 07/01/2017 06/30/2018

1908 R74904 Stein Richard Benjaphan Active 07/01/2017 06/30/2018

1908 R76105 Steinmeyer Laura A Active 07/01/2017 06/30/2018

1908 R74955 Stephens Jack Edward Active 07/01/2017 06/30/2018

1908 R75438 Stout Josephine Price Active 07/01/2017 06/30/2018

1908 R75052 Stroud Steven Chase Active 07/01/2017 06/30/2018

1908 R76111 Stupinski John A Active 07/01/2017 06/30/2018

1908 R73944 Sugandi Jeffrey Anthony Active 07/01/2017 06/30/2018

1908 R74433 Sultani Masoud Ahmad Active 07/01/2017 06/30/2018

1908 R76104 Summerford Katina M Active 07/01/2017 06/30/2018

1908 R75065 Sun Belinda Liu Active 07/01/2016 06/30/2017

1908 R74374 Suszko Justin William Active 07/01/2017 06/30/2018

1908 R74906 Swartz Grant Gerard Active 07/01/2017 06/30/2018

1908 R73945 Syed Nida Javed Active 07/01/2016 06/30/2017

1908 R75550 Symms John Thomas Active 07/01/2017 06/30/2018

1908 R74575 Ta Tuong Chi Active 07/01/2016 06/30/2017

1908 R76053 Tandyasraya Prita M Active 07/01/2017 06/30/2018

1908 R73946 Tang Schirin Active 07/01/2016 06/30/2017

1908 R73307 Tay Jennifer Active 07/01/2016 06/30/2017

1908 R74378 Tesar Lindsay Diane Active 07/01/2016 06/30/2017

1908 R72523 Testa David Carmine Active 07/01/2016 06/30/2017

1908 R74630 Thongkham Jaylong Wong Active 07/01/2017 06/30/2018

1908 R73397 Tieman Joshua Thomas Shane Active 07/01/2017 06/30/2018

1908 R74390 Tong Simon Charles Active 07/01/2016 06/30/2017

1908 R75602 Tongchinsub Pamela Panapor. Active 07/01/2017 06/30/2018

1908 R75439 Tran Kim Anh Active 07/01/2017 06/30/2018

1908 R74902 Tribelhorn Elizabeth Marie... Active 07/01/2017 06/30/2018

1908 R75495 Trinidad Bradley James Active 07/01/2017 06/30/2018

1908 R74967 Trost Jaren Robert Active 07/01/2017 06/30/2018

1908 R76144 Trujillo Tysen K Active 07/01/2017 06/30/2018

1908 R76012 Truong Danh C Active 07/01/2017 06/30/2018

Page Number 37 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R73948 Trutter Lindsey Renee Active 07/01/2016 06/30/2017

1908 R76023 Tsang Victoria Lj Active 07/01/2017 06/30/2018

1908 R76096 Turchioe Brian J Active 07/01/2017 06/30/2018

1908 R74030 Unger Wyatt Daniel Active 07/01/2016 06/30/2017

1908 R75027 Urata Kiel Frederick Active 07/01/2016 06/30/2017

1908 R76024 Urquijo Martyn Active 07/01/2017 06/30/2018

1908 R71257 Valenzuela Yunuen Manuel Active 07/01/2017 06/30/2018

1908 R75710 Varma Elly Active 07/01/2017 06/30/2018

1908 R75540 Varner Samantha Elizabeth Active 07/01/2017 06/30/2018

1908 R74910 Velasco Omar Active 07/01/2017 06/30/2018

1908 R75722 Venkatraman Sneha Lakshmi Active 07/01/2017 06/30/2018

1908 R75314 Villavincencio Sumire Enri... Active 07/01/2016 06/30/2017

1908 R72908 Villegas Cassandra Vanessa... Active 07/01/2016 06/30/2017

1908 R75598 Vo Elise Taylor Active 07/01/2017 06/30/2018

1908 R75523 Vondrak Jessica Lucia Active 07/01/2017 06/30/2018

1908 R75164 Voss Kristina Active 07/01/2017 06/30/2018

1908 R75586 Wa Christianne April Active 07/01/2017 06/30/2018

1908 R74468 Walpert Adam Samuel Active 07/01/2016 06/30/2017

1908 R75513 Wannemacher Jacob Paul Active 07/01/2017 06/30/2018

1908 R75047 Ward Timothy D Active 07/01/2017 06/30/2018

1908 R75664 Warhadpande Devdutta Sanja. Active 07/01/2017 06/30/2018

1908 R76103 Warner Joshua D Active 07/01/2017 06/30/2018

1908 R74381 Watkins Brenton Thomas Active 07/01/2016 06/30/2017

1908 R73312 Weber Joel Robert Active 07/01/2016 06/30/2017

1908 R74975 Wei Ruth Man Huen Active 07/01/2017 06/30/2018

1908 R73313 Weinkauf Craig Carleton Active 07/01/2016 06/30/2017

1908 R75024 Wensman Sierra Kai Chandle.. Active 07/01/2017 06/30/2018

1908 R74382 Wentworth Sean Sawyer Active 07/01/2016 06/30/2017

1908 R74887 West Colin Andrew Active 07/01/2017 06/30/2018

1908 R75587 Wickenheiser Marilyn R Active 07/01/2017 06/30/2018

1908 R75035 Wickers Brian Michael Active 07/01/2017 06/30/2018

1908 R75220 Williams Keneeshia Nicole Active 07/01/2016 06/30/2017

Page Number 38 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona 1908 R73951 Wilson Bryan Zoran Active 07/01/2016 06/30/2017

1908 R76029 Wilson Jared R Active 07/01/2017 06/30/2018

1908 R76033 Winkler Garret A III Active 07/01/2017 06/30/2018

1908 R74995 Winsor Kimberly Schmelzle Active 07/01/2017 06/30/2018

1908 R73952 Witt Norina Danielle Active 07/01/2016 06/30/2017

1908 R73953 Wolf Craig Jason Active 07/01/2016 06/30/2017

1908 R74943 Wong Ryan Christopher Active 07/01/2017 06/30/2018

1908 R74532 Woods Dominque Michelle Active 07/01/2016 06/30/2017

1908 R74107 Wormley Molly Christine Active 07/01/2017 06/30/2018

1908 R75591 Wu Christopher Chen Active 07/01/2017 06/30/2018

1908 R76157 Yadav Kapil Active 07/01/2017 06/30/2018

1908 R76106 Yang Yan Active 07/01/2017 06/30/2018

1908 R73954 Yanquez Federico Javier Active 07/01/2017 06/30/2018

1908 R74624 Yates Brandon Lee Active 07/01/2017 06/30/2018

1908 R75546 Ynosencio Tiffany Karla Active 07/01/2017 06/30/2018

1908 R75852 Yogendran Lalanthica Vilas... Active 07/01/2017 06/30/2018

1908 R74383 Yoo Brian Junghyun Active 07/01/2017 06/30/2018

1908 R75218 Young Krista Jinmi Active 07/01/2016 06/30/2017

1908 R75545 Young Richard Benjamin Active 07/01/2017 06/30/2018

1908 R74989 Youngs Carl Richard Active 07/01/2017 06/30/2018

1908 R73955 Yu Soojie Active 07/01/2017 06/30/2018

1908 R74384 Yumul Ily Kristine Tolenti... Active 07/01/2016 06/30/2017

1908 R74577 Zahedieh Sareh Active 07/01/2016 06/30/2017

1908 R72828 Zangeneh Bianca Santoni Active 07/01/2016 06/30/2017

1908 R76088 Zhang Bo Active 07/01/2017 06/30/2018

1908 R75453 Zhou Andrew Xingyu Active 07/01/2017 06/30/2018

1908 R76143 Zimmerman Steven A Active 07/01/2017 04/30/2018

University of Arizona College of Medicine at South Campus

1908 R75355 Ajayi-Obe Akinbola Adewole... Active 07/01/2017 06/30/2018

1908 R75303 Alba Michele Katherine Active 07/01/2017 06/30/2018

1908 R74604 Anand Senthil Active 07/01/2016 06/30/2017

1908 R75743 Balakrishnan Mahesh Kumarr.. Active 06/23/2017 06/22/2018

1908 R74606 Bates Jessica Suzanne Active 07/01/2016 06/30/2017

Page Number 39 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine at South Campus

1908 R75129 Bellafiore Amber Lee Active 07/01/2017 06/30/2018

1908 R75735 Berjaoui Chadi Active 06/23/2017 06/22/2018

1908 R75130 Bertels Karen M Active 07/01/2017 06/30/2018

1908 R75786 Bijin Babitha Active 07/01/2017 06/30/2018

1908 R75744 Britt Jeremy Active 06/23/2017 06/22/2018

1908 R73899 Cala Lindsay Marie Active 07/01/2016 06/30/2017

1908 R75313 Cappe Zoe A Active 07/01/2017 06/30/2018

1908 R75125 Castellano Tiffany Marie Active 07/01/2017 06/30/2018

1908 R74610 Clutter Joshua Paul Active 07/01/2016 06/30/2017

1908 R75131 Conley Robert Benjamin Active 07/01/2017 06/30/2018

1908 R75729 Curtis Kurt Alexander Active 06/23/2017 06/22/2018

1908 R75730 Dechant Ross David Active 06/23/2017 06/22/2018

1908 R75731 Ely Gregory James Active 06/23/2017 06/22/2018

1908 R75737 Engel Brian Scott Active 06/23/2017 06/22/2018

1908 R75738 Galaviz Andrea Christina Active 06/23/2017 06/22/2018

1908 R74753 Goetz Patrick Jochen Active 07/01/2016 06/30/2017

1908 R75132 Goldberg Lisa Caryn Active 07/01/2017 06/30/2018

1908 R75311 Goldlist Kady Active 07/01/2017 06/30/2018

1908 R74611 Griffin Marvin Bradley Active 07/01/2016 06/30/2017

1908 R75732 Hannan Philipp Lorenz Active 06/23/2017 06/22/2018

1908 R75133 Hernandez Nicholas Clayton... Active 07/01/2017 06/30/2018

1908 R75733 Higa Kelcy Active 06/23/2017 06/22/2018

1908 R75126 Horstman Todd Anthony Active 07/01/2017 06/30/2018

1908 R74612 Houmes Katie Jean Active 07/01/2016 06/30/2017

1908 R74754 Husnain Muhammad Active 07/01/2016 06/30/2017

1908 R75739 Hutchison Sarah Morgan Active 06/23/2017 06/22/2018

1908 R75312 Jonnadula Jayasree J Active 07/01/2017 06/30/2018

1908 R75315 Kannaiyan Radhamani Active 07/01/2017 06/30/2018

1908 R74614 Keyser Andrew Robert Active 07/05/2016 06/30/2017

1908 R75826 Khare Supreet Active 07/01/2017 06/30/2018

1908 R75734 Kim Daewon Active 06/23/2017 06/22/2018

1908 R74749 Lakshmanan Reuben Active 07/29/2016 06/30/2017

Page Number 40 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine at South Campus

1908 R75134 Lederer Eric Thomas Active 07/01/2017 06/30/2018

1908 R75127 Losey Kaitlyn Rose Active 07/01/2017 06/30/2018

1908 R75122 Marquez Jose Luis Active 07/01/2017 06/30/2018

1908 R75044 McInnis Colin Patrick Active 07/01/2017 06/30/2018

1908 R75128 Mendez Ana M Active 07/01/2017 06/30/2018

1908 R72379 Mora Francisco Esteban Active 07/01/2017 06/30/2018

1908 R75123 Natarajan Balaji Active 07/01/2017 06/30/2018

1908 R73488 Ori Michael Robert Active 07/01/2016 06/30/2017

1908 R75745 Orta Daniel Luis Active 06/23/2017 06/22/2018

1908 R75316 Pang Rui Wen Active 07/01/2017 06/30/2018

1908 R74616 Patel Jason Pankaj Active 07/01/2016 06/30/2017

1908 R75740 Patterson Ralph Adam Active 06/23/2017 06/22/2018

1908 R75746 Power Emilio Antonio Active 06/23/2017 06/22/2018

1908 R74618 Price Grace Lorna Active 07/01/2016 06/30/2017

1908 R73923 Prospero Ponce Claudia Mar... Active 07/01/2016 06/30/2017

1908 R75789 Raoof Sidra Active 07/01/2017 06/30/2018

1908 R74620 Saenz Joe Anthony Active 07/01/2016 06/30/2017

1908 R75318 Saint Aubyn Jenny Farah Active 07/01/2017 06/30/2018

1908 R73476 Sandoval Gonzalez Juan Adr... Active 07/01/2016 06/30/2017

1908 R74621 Semmens Shana Elizabeth Active 07/01/2016 06/30/2017

1908 R73303 Simard Theresa Rose Active 07/01/2016 06/30/2017

1908 R75124 Singh Nirmal Active 07/01/2017 06/30/2018

1908 R74622 Smith Scott Christian Active 07/01/2016 06/30/2017

1908 R74028 Stevenson William Thomas Active 07/01/2016 06/30/2017

1908 R75748 Stockdall Chandra Beth Active 07/01/2017 06/30/2018

1908 R74623 Stone Myles Joseph Active 07/01/2016 06/30/2017

1908 R75118 Swazo Roberto Carlos Active 07/01/2017 06/30/2018

1908 R75827 Tariq Sarah Active 07/01/2017 06/30/2018

1908 R75742 Teramoto Kyla Miyuki Active 06/23/2017 06/22/2018

1908 R73522 Teran Marcos Andres Active 07/01/2017 06/30/2018

1908 R74751 Tey Kai Rou Active 07/01/2016 06/30/2017

1908 R75119 Wang Jillian Active 07/01/2017 06/30/2018

Page Number 41 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine at South Campus

1908 R75741 Wang Patty Active 06/23/2017 06/22/2018

1908 R75120 Werner Samuel Chase Active 07/01/2017 06/30/2018

1908 R75301 Wong Wei Xiang Active 07/01/2017 06/30/2018

1908 R74626 Yekta Shabnam Active 07/01/2016 06/30/2017

1908 R75747 Yousman Wina P Active 06/23/2017 06/22/2018

University of Arizona College of Medicine-Phoenix 1908 R73854 Aarsvold Kelly Jean Active 07/01/2016 06/30/2017

1908 R75670 Abreu Shawn David Active 06/23/2016 06/22/2017

1908 R75771 Aguayo Izayadeth Active 06/23/2016 06/22/2017

1908 R73398 Aguirre Andrea Graciela Active 06/23/2016 06/22/2017

1908 R74398 Ahmad Zeshan Khan Active 07/01/2016 06/30/2017

1908 R75671 Albasha Waseem Active 06/23/2016 06/22/2017

1908 R75054 Alcantar Eduardo Contreras... Active 06/22/2016 06/21/2017

1908 R75056 Andersen Amanda S Active 07/01/2016 06/30/2017

1908 R75057 Anduaga Bocanegra Susan Pa Active 07/01/2016 06/30/2017

1908 R75829 Arreola Angela Sabrina Active 06/21/2016 06/20/2017

1908 R73498 Assar Seth Mahmood Active 07/01/2016 06/30/2017

1908 R75772 Ayeni Olubukunola Active 08/01/2016 07/31/2017

1908 R73588 Babcock Kelley Danice Active 06/25/2016 06/24/2017

1908 R74315 Backstedt David Walter Active 07/01/2016 06/30/2017

1908 R75059 Bagheri Ramin Daniel Active 07/01/2016 06/30/2017

1908 R74399 Barber Collin Chase Active 06/23/2016 06/22/2017

1908 R74316 Basnyat Rose Active 07/01/2016 06/30/2017

1908 R73819 Bay Elizabeth Ann Active 07/01/2016 06/30/2017

1908 R74317 Behbahaninia Milad Active 06/23/2016 06/22/2017

1908 R75773 Bentley Christina Elaina Active 06/23/2016 06/22/2017

1908 R73799 Bernhard Anita Active 06/24/2016 06/23/2017

1908 R75673 Bettini Layne Mauro Active 06/23/2016 06/22/2017

1908 R75322 Bhatt Divya Bipinchandra Active 07/01/2016 06/30/2017

1908 R75674 Bhattarai Richa Active 07/01/2016 06/30/2017

1908 R75675 Boltz Mandy Ward Active 06/23/2016 06/22/2017

1908 R75275 Borodulin Olga Active 06/23/2016 06/22/2017

1908 R75774 Bowen Trenton James Active 06/23/2016 06/22/2017

Page Number 42 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine-Phoenix 1908 R75775 Brewer Brett Joseph Active 06/23/2016 06/22/2017

1908 R74318 Brink Janel Nicole Active 06/23/2016 06/22/2017

1908 R75060 Broker Paul Michael Active 07/01/2016 06/30/2017

1908 R75776 Brown Matthew Joel Active 08/01/2016 07/31/2017

1908 R74319 Brown Tanida Lee Active 07/01/2016 06/30/2017

1908 R75777 Buchanan Jenna Leigh Active 06/23/2016 06/22/2017

1908 R74517 Burns Jessica Davis Active 06/23/2016 06/22/2017

1908 R75077 Burrow Jeffrey Parker Active 07/01/2016 06/30/2017

1908 R74099 Buschmann Cory Miles Active 06/24/2016 06/23/2017

1908 R74697 Campodonico Joanna Judith Active 07/01/2016 06/30/2017

1908 R75779 Canestraro Anthony John Active 06/23/2016 06/22/2017

1908 R73800 Chakrabarty Melony Active 07/01/2016 06/30/2017

1908 R75078 Chen Joseph Sc Active 06/23/2016 06/22/2017

1908 R73801 Chong David Leo Active 07/01/2016 06/30/2017

1908 R75201 Chopra Madhav Active 07/01/2016 06/30/2017

1908 R74400 Choulet Samuel Ryan Active 07/01/2016 06/30/2017

1908 R74516 Cochran Ernest Winston Active 07/01/2016 06/30/2017

1908 R73820 Cowan Mark Joel Active 06/24/2016 06/23/2017

1908 R75080 Cowles Steven Daniel Active 06/23/2016 06/22/2017

1908 R75780 Crigger Morgan Joseph Active 06/21/2016 06/20/2017

1908 R75842 Crow Lauren Duffey Active 06/23/2016 06/22/2017

1908 R75676 Curry Craig L Active 06/23/2016 06/22/2017

1908 R74566 Daily Elizabeth Brett Active 07/01/2016 06/30/2017

1908 R75081 Dash Suchismita Active 07/01/2016 06/30/2017

1908 R75828 Davis Suzanne Joyce Active 06/23/2016 06/22/2017

1908 R73437 Dawson Christopher Chad Active 06/25/2016 06/24/2017

1908 R75830 Decuffa Matthew Raymond Active 06/23/2016 06/22/2017

1908 R74406 Detlefs Sarah Ellen Active 06/23/2016 06/22/2017

1908 R75781 Digiovanni Ryan M Active 06/22/2016 06/21/2017

1908 R74401 Dodaro Gregory Charles Active 07/01/2016 06/30/2017

1908 R75082 Drutel Robert Oliver Active 07/01/2016 06/30/2017

1908 R75079 Duran Michael Dean Active 06/23/2016 06/22/2017

Page Number 43 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine-Phoenix 1908 R76057 Dy Prudence Kho Active 07/01/2017 07/31/2017

1908 R73852 Edet Itoro Bassey Active 07/01/2016 06/30/2017

1908 R72646 Edgerton Joshua Kenneth Active 06/19/2016 06/18/2017

1908 R75543 Ellsworth Kevin Ryan Active 07/05/2016 07/29/2017

1908 R74320 Emerick Lindsay Erin Active 06/23/2016 06/22/2017

1908 R75677 Espinoza Magdalena Active 07/01/2016 06/30/2017

1908 R75084 Eustis Dana Grace Active 06/23/2016 06/22/2017

1908 R73821 Evans Kari Lynn Active 06/22/2016 06/21/2017

1908 R75083 Eyberg Blake Alan Active 06/23/2016 06/22/2017

1908 R72647 Flores Erica Michele Active 07/01/2016 06/30/2017

1908 R74044 Fountain Stephanie Michell... Active 07/01/2016 06/30/2017

1908 R73851 Fox Melissa Ann Active 06/22/2016 06/21/2017

1908 R75782 Fraker Jessica Leigh Active 06/23/2016 06/22/2017

1908 R75087 Garcia Christian Rosario Active 06/23/2016 06/22/2017

1908 R75783 George Maya Sera Active 06/23/2016 06/22/2017

1908 R75704 German Massiell Lourdes Active 06/23/2016 06/22/2017

1908 R73393 Goltzer Oren Active 06/25/2016 06/24/2017

1908 R73731 Gonzalez Jennifer Active 10/10/2016 10/09/2017

1908 R74407 Goodwin Jill Anne Active 06/23/2016 06/22/2017

1908 R75831 Gorur Arathi Meghana Active 06/23/2016 06/22/2017

1908 R74413 Gottesman Bowen Bethany Ly. Active 07/01/2016 06/30/2017

1908 R75787 Graves Matthew John Active 06/23/2016 06/22/2017

1908 R75788 Groom Meg Louise Active 06/23/2016 06/22/2017

1908 R75832 Hahn Laura Elizabeth Active 06/23/2016 06/22/2017

1908 R74039 Hashemi Mohammad Sina Active 07/01/2016 06/30/2017

1908 R74321 Hayward Nathaniel III Active 07/01/2016 06/30/2017

1908 R75273 Higashi Ashley Sohn Active 07/01/2016 06/30/2017

1908 R73806 Higley Jeffrey Blake Active 06/22/2016 06/21/2017

1908 R74568 Hise Luke Williams Active 07/01/2016 06/30/2017

1908 R75790 Hoffman Laura Ann Active 06/21/2016 06/20/2017

1908 R75791 Hoidal Kelsey Elizabeth Su... Active 06/21/2016 06/20/2017

1908 R75833 Hollweg Christopher Andrew... Active 07/01/2016 06/30/2017

Page Number 44 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine-Phoenix 1908 R75093 Hong Willis Chia-Wei Active 06/23/2016 06/22/2017

1908 R75792 Hopp Alix Chen Active 06/23/2016 06/22/2017

1908 R73394 Hosack Luke William Active 06/25/2016 06/24/2017

1908 R72839 Hourani Christian Adib Active 07/01/2016 06/30/2017

1908 R74015 Hustedt Joshua William Active 06/24/2016 06/23/2017

1908 R75893 Irime Ioana Manuela Active 08/01/2016 07/31/2017

1908 R75094 Islam Sumaiya Mahbuba Active 07/01/2016 06/30/2017

1908 R71536 Johnson Kristopher Brandon... Active 06/19/2016 06/18/2017

1908 R75797 Johnson Pierce Cameron Active 06/22/2016 06/21/2017

1908 R73808 Kanner Joshua Aaron Active 07/01/2016 06/30/2017

1908 R74322 Karr Sean Douglas Active 06/23/2016 06/22/2017

1908 R73462 Kayani Arooj Sohaib Active 07/01/2016 06/30/2017

1908 R74417 Kirk Katy Anne Active 07/01/2016 06/30/2017

1908 R74323 Kirkorsky Scott Eric Active 07/01/2016 06/30/2017

1908 R74515 Kloos Erin Michelle Active 06/23/2016 06/22/2017

1908 R75834 Kobayashi Akihiro Active 07/01/2016 06/30/2017

1908 R75097 Koch Robert Clinton Active 07/01/2016 06/30/2017

1908 R75098 Koenig Anna Lise Active 06/22/2016 06/21/2017

1908 R75798 Koike Kimberly Louise Active 06/23/2016 06/22/2017

1908 R74514 Kuch Amanda Ethel Active 07/01/2016 06/30/2017

1908 R74038 Kumar Daveshni Active 06/24/2016 06/23/2017

1908 R73466 Kumar Rashmi Active 07/01/2016 06/30/2017

1908 R73388 Lawson Sarah Margaret Active 06/25/2016 06/24/2017

1908 R75276 Lebeau Christopher John Jr... Active 07/01/2016 06/30/2017

1908 R75799 Lee Audrey Alexandria Active 06/23/2016 06/22/2017

1908 R74046 Lee James Jinkun Active 06/24/2016 06/23/2017

1908 R75269 Lekic Mateja Active 07/01/2016 06/30/2017

1908 R74011 Leovic Michael Phillip Active 06/22/2016 06/21/2017

1908 R73858 LeSueur Philip Michael Active 07/01/2016 06/30/2017

1908 R75800 Lish James Robert Active 06/23/2016 06/22/2017

1908 R75835 Lo Andrew Yung Active 06/23/2016 06/22/2017

1908 R75100 Ludwig Rebecca Ann Active 06/23/2016 06/22/2017

Page Number 45 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine-Phoenix 1908 R74567 Luer Alexander Max Active 07/01/2016 06/30/2017

1908 R75793 Madden Heather Hyland Active 06/23/2016 06/22/2017

1908 R75323 Madrigal Calvin Geoffrey Active 07/01/2016 06/30/2017

1908 R75802 Maestas Camila M Active 06/23/2016 06/22/2017

1908 R75803 Maher Robert Lawrence Active 06/21/2016 06/20/2017

1908 R74001 Malashock Hannah Rose Active 07/01/2016 06/30/2017

1908 R74518 Manson Jerome Keith Active 06/23/2016 06/22/2017

1908 R74527 Marallag Marnonette Juan Active 07/01/2016 06/30/2017

1908 R75804 Marston Thomas W Active 06/23/2016 06/22/2017

1908 R75274 Matthews Abby June Active 07/01/2016 06/30/2017

1908 R73848 McEwen Cole Jamison Active 06/24/2016 06/23/2017

1908 R74529 McKenzie Tina Marie Active 07/01/2016 06/30/2017

1908 R74410 McMillen Zoe Linda Active 07/01/2016 06/30/2017

1908 R74412 Mehr Britton Peirce Active 06/23/2016 06/22/2017

1908 R74513 Memmott Regan Michelle Active 07/01/2016 06/30/2017

1908 R75108 Merz Alexa Elizabeth Active 06/22/2016 06/21/2017

1908 R75106 Merz Jordan Patrick Active 07/01/2016 06/30/2017

1908 R75805 Mitchell Sean Michael Active 06/22/2016 06/21/2017

1908 R75149 Mohammed Arif Salam Active 07/01/2016 06/30/2017

1908 R75822 Molloy Shaida M Active 06/23/2016 06/22/2017

1908 R75110 Muhleisen Alicia Lynn Active 06/23/2016 06/22/2017

1908 R75806 Muna Aguon Paul Alfred Active 06/23/2016 06/22/2017

1908 R75105 Murphy Christopher Samuel Active 07/01/2016 06/30/2017

1908 R74512 Muscha Brittany Rae Active 07/01/2016 06/30/2017

1908 R75807 Nafisi Shirin Active 06/23/2016 06/22/2017

1908 R75808 Naim Alan Joseph Active 07/01/2016 06/30/2017

1908 R75111 Nandi Indrajit Active 07/01/2016 06/30/2017

1908 R74511 Nguyen Peter H Active 07/01/2016 06/30/2017

1908 R74414 Nwobodo Junior Chideralum Active 07/01/2016 06/30/2017

1908 R74332 O'keefe Kevin Joseph Active 07/01/2016 06/30/2017

1908 R74415 Olson Kurt Lewis Active 07/01/2016 06/30/2017

1908 R75112 Parina Ralitza Petrova Active 06/22/2016 06/21/2017

Page Number 46 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine-Phoenix 1908 R73390 Park Shin Young Active 07/01/2016 06/30/2017

1908 R72844 Patel Amitkumar S Active 07/01/2016 06/30/2017

1908 R75115 Patel Mayur P Active 07/01/2016 06/30/2017

1908 R73863 Patel Raj Babu Active 06/24/2016 06/23/2017

1908 R73855 Pena Alejandro Jr Active 07/01/2016 06/30/2017

1908 R75113 Petersen Eric Hoang Active 06/22/2016 06/21/2017

1908 R73815 Peterson Kate Elizabeth Active 06/22/2016 06/21/2017

1908 R73443 Pineda Guerrero Gerson Orl... Active 06/25/2016 06/24/2017

1908 R75840 Prakash Sheena Amy Active 07/01/2016 06/30/2017

1908 R75266 Pressley Shari Renee Active 07/01/2016 06/30/2017

1908 R74829 Puri Akshjot Active 12/15/2016 12/14/2017

1908 R74523 Quiner Trevor Elisha Active 06/23/2016 06/22/2017

1908 R75809 Radecki Melissa Anne Active 08/01/2016 07/31/2017

1908 R74571 Ramanathan Meera Active 07/01/2016 06/30/2017

1908 R75810 Rasheed Anita Fazal Active 06/23/2016 06/22/2017

1908 R75117 Reichert William Byron Active 07/01/2016 06/30/2017

1908 R75812 Reshef Evan Akiva Active 06/23/2016 06/22/2017

1908 R73445 Richardson Damien Arnold Active 06/25/2016 06/24/2017

1908 R74510 Robbins Hailey Nicole Active 06/23/2016 06/22/2017

1908 R73395 Roberts Justin Michael Active 06/25/2016 06/24/2017

1908 R75813 Robertson Kirstin Alexis Active 06/23/2016 06/22/2017

1908 R74416 Rogers Michael Joseph Active 07/01/2016 06/30/2017

1908 R75103 Rowley Michael William Active 07/01/2016 06/30/2017

1908 R74333 Ruggle Adam Forrest Active 07/01/2016 06/30/2017

1908 R75151 Salehpour Kaivan Majid Active 07/01/2016 06/30/2017

1908 R75814 Sander Jared Marcus Active 06/23/2016 06/22/2017

1908 R74325 Saunders Kelley Thompson Active 06/23/2016 06/22/2017

1908 R75815 Schmidgall Matthew Akira Active 06/23/2016 06/22/2017

1908 R75837 Schultz Sondra Marie Active 06/23/2016 06/22/2017

1908 R73447 Scott Grant Robert Active 06/25/2016 06/24/2017

1908 R74528 See Wade William Active 06/23/2016 06/22/2017

1908 R75816 Seelbaugh Joseph Paul Active 06/23/2016 06/22/2017

Page Number 47 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

University of Arizona College of Medicine-Phoenix 1908 R74418 Seibolt Lucas Paul Active 07/01/2016 06/30/2017

1908 R72664 Sein Vicki Active 06/19/2016 06/18/2017

1908 R75974 Serio Sean Daniel Active 08/26/2017 09/23/2017

1908 R74525 Shamsid-Deen Nafis Ansari Active 07/01/2016 06/30/2017

1908 R73861 Shelhamer Ryan Paul Active 06/24/2016 06/23/2017

1908 R75817 Shroads Michael Rocco Active 06/23/2016 06/22/2017

1908 R75818 Silver Aaron Michael Active 06/23/2016 06/22/2017

1908 R75327 Simpson Emma Louise Active 08/03/2016 08/02/2017

1908 R75158 Sloan Jessica Kate Active 06/22/2016 06/21/2017

1908 R73860 Smrekar Lisa Michelle Active 06/22/2016 06/21/2017

1908 R75819 Soholt Molly Ann Active 06/23/2016 06/22/2017

1908 R75836 Stoddard Michael Active 06/23/2016 06/22/2017

1908 R73817 Sultan Michael Ha Active 07/01/2016 06/30/2017

1908 R74569 Tallarita Tiziano Active 06/23/2016 06/22/2017

1908 R74328 Thomson Nicholas Christens... Active 07/01/2016 06/30/2017

1908 R75838 Thornley Caitlin Jayne Active 06/21/2016 06/20/2017

1908 R75267 Udoko Mfonobong Nsima Active 07/01/2016 06/30/2017

1908 R75839 Van Pelt Chad Michael Active 06/23/2016 06/22/2017

1908 R75820 Volkert Angela Luanne Imme... Active 06/23/2016 06/22/2017

1908 R75165 Walker Joseph Brock Active 06/23/2016 06/22/2017

1908 R75821 Walker Robert Stephen Active 06/22/2016 06/21/2017

1908 R75268 Wang Ryan Yinghan Active 07/01/2016 06/30/2017

1908 R75166 Watters Emily Joy Active 06/22/2016 06/21/2017

1908 R75167 Weise-fleckenstein Maria D... Active 06/23/2016 06/22/2017

1908 R74329 Werk Evan Frank Active 07/01/2016 06/30/2017

1908 R75823 Wey Emily A Active 06/23/2016 06/22/2017

1908 R75168 Wheeler Kellie Deane Active 07/01/2016 06/30/2017

1908 R74419 Wong Allen Chun-Kit Active 07/01/2016 06/30/2017

1908 R75169 Yazdchi Siamac Active 07/01/2016 06/30/2017

1908 R75824 Yunus Asfiya Active 06/23/2016 06/22/2017

1908 R75170 Zheng Albert Yimon Active 07/01/2016 06/30/2017

1908 R73730 Zuberi Sahar Shakir Active 07/18/2016 07/17/2017

Page Number 48 of 49

Arizona Medical Board

Facility Lictype License Num Licensee Status Start Date End Date

WBAMC/Chandler Regional Medical Center 1908 R74772 Cleveland Elaine Marie Active 03/01/2017 02/28/2018

1908 R74831 Miller Elizabeth Ann Active 07/01/2016 06/30/2017

1908 R74287 Muir Kathryn Bethany Active 06/01/2016 05/31/2017

1908 R75892 Reitz Cara Leigh Active 11/17/2016 11/16/2017

1908 R75324 Roubik Daniel John Active 11/01/2016 10/31/2017

1908 R75891 Schultz Susan Phebe Active 09/15/2016 09/14/2017

1908 R75413 Sirkin Maxwell R Active 05/01/2017 04/30/2018

1908 R74816 Swann Jacob Andrew Active 03/01/2017 02/28/2018

1908 R75102 Viera Jennifer Lynn Active 08/31/2017

1908 R74834 Williams Matthew Rand Active 02/01/2017 01/31/2018

Yuma Regional Medical Center 1908 R75263 Aamer Muhammad Active 06/29/2016 06/28/2017

1908 R75851 Alemayehu Martha Tersit Active 07/01/2016 06/30/2017

1908 R74478 Alsaiegh Nada Active 07/02/2016 07/01/2017

1908 R75784 Alvarez Angelic Marie Active 07/01/2016 06/30/2017

1908 R75204 Baig Adil M Active 06/29/2016 06/28/2017

1908 R75205 Boparai Rajni Kaur Active 06/29/2016 06/28/2017

1908 R75270 Carvalho Giselle De Active 06/29/2016 06/28/2017

1908 R74476 Casey Ryan Patrick Active 07/02/2016 07/01/2017

1908 R75206 Fink Sayda Livier Active 06/29/2016 06/28/2017

1908 R73723 Galarza Carrazco Natalia V... Active 07/02/2016 07/01/2017

1908 R74519 Hogue Joseph Daniel Active 07/02/2016 07/01/2017

1908 R74477 Jacobson Bjorn Allan Active 07/02/2016 07/01/2017

1908 R73432 Kumar Navaneeth Chandru Active 07/26/2016 07/25/2017

1908 R75795 Nevarez Alfredo Active 07/01/2016 06/30/2017

1908 R75796 Oba Uchechukwu Kenneth Active 07/01/2016 06/30/2017

1908 R75207 Orfali Dikran Active 06/29/2016 06/28/2017

1908 R75785 Rajai Salem Alrabadi Saif ... Active 07/01/2016 06/30/2017

1908 R74475 Vega Jose Luis III Active 07/02/2016 07/01/2017

1908 R74505 Venkateswaran Ayesha Priya... Active 07/02/2016 07/01/2017

Page Number 49 of 49 Revised: 05/11/2017

Arizona Medical Board

top related