georgia composite medical board minutes of the january 9

Georgia Composite Medical Board

Minutes of the January 9, 2020 Meeting

1

The Georgia Composite Medical Board (GCMB) held its regular meeting on January 9, 2020, at

2 Peachtree Street, Atlanta, GA 30303, to consider Medical Board matters.

Board members present:

John S. Antalis, MD

Gretchen Collins, MD, Chair

Debi Dalton, MD

E. Dan DeLoach, MD

Alexander Gross, MD

Thomas Harbin, MD

Rob Law, CFA

J. Jeffery Marshall, MD

Matthew Norman, MD

David Retterbush, MD

Richard Weil, MD

Board members absent:

Charmaine Faucher, PA (ex-officio)

Andrew Reisman, MD

Barby Simmons, DO, Vice Chair

Management and legal staff present:

LaSharn Hughes, MBA, Executive Director

Lisa Norris, MPH, Deputy Executive Director

Phyllis Douglas, JD, Legal Services Officer

D. Williams-McNeely, Senior Assistant Attorney General

Max Changus, JD, Assistant Attorney General

Phyllis White, Executive Assistant

Latisha Bias, Enforcement Supervisor

Gina Haskins, Licensure Manager

CALL TO ORDER

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

AGENDA

Dr. Weil submitted a motion, seconded by Dr. Antalis to approve the agenda of the

January 9, 2020 meeting. The motion carried unanimously.

MINUTES

Dr. Retterbush made a motion to approve the minutes of the December 5, 2019 meeting. Dr.

Marshall seconded the motion and it carried unanimously.

CHAIR’S REPORT

Dr. Collins made the following report:

1. Appointed Dr. Dalton Chair of RCP.

2. The Board has been invited to swearing in of new members today.

3. I will make Committee assignments for the new members today.

4. Reminder of off-site board meetings: PCOM June 4th and MCG, November 5-6.



2

EXECUTIVE DIRECTOR’S REPORT

Ms. Hughes made the following report:

1. Letter from Radha Bachman regarding Disposition of Medical Records. The family had

made every effort for the past year. Refer to the Attorney General’s Office.

2. FY – Article “Bid to loosen rules on mid-levels providers draws legislative debate.”

3. FYI – (FSMB) Proposed FSMB 2020-2025 Strategic Plan.

4. FYI – (FSMB) Senate Passes Gardner VA Accountability Legislation

5. FYI – Trinity School of Medicine Annual Report and update provided for next steps.

The Board to advise Dr. Skelton to submit the information to the National Committee on

Foreign Medical Education and Accreditation.

6. Email from John Groover regarding Board’s position on allowing a physician to execute

an arbitration clause relating to billing and/or medical care. Not within the Board’s scope.

RULES HEARING REPORT

Dr. Gross gave the following report.

Motion Dr. Weil seconded Dr. DeLoach to adopt the following rules:

Rule 360-3-.02(3) “Unprofessional Conduct”

Rule 360-3-.02(5) “Unprofessional Conduct”

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

CLOSED SESSION

Dr. Retterbush motioned seconded by Dr. Harbin to go into closed session to discuss

investigations and disciplinary matters, and it carried unanimously.

OPEN SESSION

Dr. Collins declared open session.

ATTORNEY GENERAL (AG)

Max Changus, Assistant Attorney General presented the Attorney General Status Report.

Dr. Antalis submitted a motion, seconded by Dr. Weil and motion carried to accept the report

and the following order:

Zackery Solomon, Interim Suspension Order.



3

RECESS

Dr. Collins declared the meeting in recess for holding committee meetings and the swearing in

ceremony.

RECONVENE

Dr. Collins reconvened the meeting at 2:00 p.m.

PHYSICIAN LICENSURE COMMITTEE

Dr. Retterbush presented the Licensure Committee Report:

The Board took the following actions:

Applications Not Approved

JVR Allow to withdraw, or deny.

JH Clinical skills assessment, allow to withdraw or deny.

LS Clinical skills assessment, allow to withdraw or deny.

CM Allow to withdraw, or deny, or Administrative License.

MB Deny or allow to withdraw.

JS Interview.

FH Table for Petition to Waive Rule.

GI Table for additional information.

Applications Approved

Gao, Xing

Goad, Bradley

Lee, Emily

Harbolovic, Robert

Gira, Joseph

Pesante, Maisha

Elshazali, Gasim

Vassy, William

Rao, Nisha

Richards, Constance

(RNST)

Byrd, Lelan (RNST)

Williams, Robert RNST

Wilkinson, Arthur (RNST)

Synn, Jay



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Applications Administratively Approved

Name Degree

Abad, Zoilo MD

Adekola, Henry MD

Adeyemi, Adetoun MD

Al-Dabagh, Ahmad S MD

Anderson, Scott R MD

Auxier, Melinda M, DO DO

Baker, Bradley K MD

Baker, Sarah MD

Ball, Stephen K MD

Barnick, Sandra MD

Beasley, Stephen A MD

Benavides, Oscar J MD

Bograd, Benjamin A MD

Bolarinwa, Surajudeen A MD

Boudreau, Jamie M MD

Bui, Tu MD

Burton, Tracy C MD

Cham, Roxana MD

Chan, Angela W MD

Chang, Wesley MD

Crain, Jack L MD

Crawford-Harris, Paula MD

Daraei, Paul P MD

Davidoff, Ramin MD

Davis, Yonette MD

DeFrancesco, Martin A MD

Dorociak, Jeffery MD

Elshazali, Gasim M MD

Feltman Meals, Tiffany DO

Foster, Travis C MD

Gallegos, Juan MD

Gao, Xing Gazzara, Jeffrey A, DO DO

Gellert, Lan MD

Gelsomino, Michael J MD

Genau, Young J MD

Gira, Joseph MD



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Goad, Bradley J DO

Goddard, Allison L MD

Goldberg, Baruch R MD

Habib, Mena G MD

Hall, Lawrence MD

Hall, Leaton H, Jr. MD

Hamilton, Christina M MD

Han, Zeqiu MD

Harbolovic, Robert MD

Hardy, Martin K DO

Harrison, Andrew J DO

Hazbun, Tamara L MD

Heister, Robyn MD

Henry, De'smond M MD

Hill Taylor, Dreylana S MD

Hill, Jonathan F, Jr MD

Hofstra, Clayton T MD

Hurtig, Carl MD

Hurwitz, S. R MD

Ivey, Kristopher J MD

Jiang, Yunna MD

Jones, Danielle M MD

Jones, Erin A MD

Kahan, Michael E DO

Kallas, Omar N MD

Kang, Richard MD

Kazmi, Qasim A MD

Kimsey, Mallory MD

Langley, Rhet MD

Larsen, David T MD

Lee, Emily MD

Lee, Frank B MD

Lee, Jacqueline MD

Lee, Jaeyoung MD

Lerman, Mark N MD

Lewis, Darron R MD

Mackey, Kimberly A MD

Marcus, Charles V MD

Maron, Steven P MD



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McKenzie, James MD

Meyers, Clifford W MD

Mhatre, Pradnya MD

Milesko, Steven D DO

Miller, Royce C, Jr. MD

Minka, Sarah DO

Misner, Karissa DO

Mitchell, Timothy E DO

Mok, Charles MD

Montgomery, Martha MD

Morton, David C MD

Mostafa, Safinaz MD

Moursy, Yusra MD

Nasiru, Abdulrahman O MD

NAWATHE, AMITA D MD

Nwabueze, Onyemaechi MD

Offermann, Ellen G MD

Okpagu, Brittany U MD

Oladiran, Oyebola O MD

Oviedo, Rodolfo J MD

Parikh, Neil N MD

Patel, Rakesh M MD

Pathirana, Induruwa MD

Paul, Nicole M DO

Pedersen, Cort A MD

Perricone, Adam J MD

Persaud, Rajesh MD

Pesante, Maisha MD

Peterson, Jessica DO

Pridjian, Andrew MD

Qureshi, Mushtaq H MD

Rao, Nisha MD

Rivera-Gonzalez, Luis S MD

Rothman, Marc MD

Rugnath, Dinesh MD

Runnstrom, Martin C MD

Sahlgren, Leif B DO

Saldajeno, Virgilio G MD

Santa Maria, Jed A



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Sattar, Hamid MD

Schimmel, Matthew E MD

Shastri, Uma D MD

Sigler, Elizabeth C MD

Silverman, Krista DO

Simmons, Sarah MD

Singh, Vir MD

Slifer, Michael A MD

Stark, Stacy M DO

Stewart, Douglas R MD

Stokley, Cyrenah N DO

Syed, Peyton J MD

Synn, Jay MD

Talari, Sirisha MD

Thaker, Aakar MD

Thaker, Pratik H MD

Thames, Todd MD

Thomas, Richard D MD

Tiegs, Jacob I MD

Udoji, Esther N MD

Vargas, Gina M MD

Vassy, William M MD

VERMA, RAJIV MD

Vu, Anh-Thu MD

Wade, Jenna A MD

Wakim, Ryan MD

Walker, Leisa K DO

Walls, Endia N MD

Wendell, Richard P MD

Willis, Simon M MD

Winkler, Michael A MD

Wiseman, Jamie R MD

Woska, David J MD

Yasin, Nura MD

NURSE PROTOCOL ADVISORY COMMITTEE

Dr. Gross presented the Nurse Protocol Report:

Other Business



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1. ACNP and a Radiologist with a specialty of Radiology/Vascular & Interventional

Radiology. Is this considered a comparable specialty? Yes, (Procedure Related) must

have a FORM C for the training documentation.

Closed Session

Form C:

❖ Lumpkin, Ashley (Approved)

❖ Petrella, Cynthia - no documentation

❖ Tyus, Brittney (Approved)

❖ Warren, Felecia (Approved)

The Committee reviewed and approved the following protocols under the provision of

O.C.C.A. 43-34-25.

APRN DELEGATING PHYSICIAN

Agomessou, Ablavi Carla Bedford-Dixon, MD

Baker, Antwan Bruce Gioia, MD

Bartoli, Monika Francisco Echevarria-Santiago, MD

Bright, Retta Jeffrey Winston, MD

Carney, Julie (revisit) Ayman Fareed, MD

Carter, Kariba Shaila Day, MD

Corbin, Traci James Chappuis, MD

Cote, Wilma Odell Still, DO

Czarnecke, Heather Gurpreet Ahluwalia, MD

Desrosiers, Myrlene Saman Ghaffari, DO

Dover, Eileen Lynette Stewart, MD

Economy, Lee Matthew Keadey, MD

Green, Stephanie Robert Miller, MD

Holder, Maria Kelly McCants, MD

Kelley, Brandy Gurpreet Ahluwalia, MD

Miller, Jenifer Aaron, Alizadeh, MD

Moss-Traore, Gilda Susan Blank, MD

Ogun-Semore, Olawunmi Asaf Aleem, MD

Patel. Nishaben Paresh Thanki, MD

Pollard-Manigualt, Denise James Thomsen, MD

Rushing, Stephanie Francisco Echevarra-Santiago, MD

Salimonu, Janet Roberto Norniella, MD

Smith, Allison George Stickney, MD

Thomas, Maritess Julie Allen, MD

Unogo, Cindy Catherine Christie, MD

Yates, Brittany Julian McLendon, D

Zmaj, Andrea Lynette Wilson-Phillips, MD

The Committee determined that the following protocol agreements meet the provisions of

O.C.G.A. 43-34-25 with changes.

Bradley, Jennifer Okah Anyokwu, MD

Brooks, Rhonda (revisit) James Zubernis, DO

Forehand, Randall Jose Artadi, MD



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Fraiser, Lauren (revisit) Jaymal Patel, MD

Fuson, Lindsay Robert Prudent, MD

Garritson, Natasha Jose Artadi, MD

Glisson, Dawn (revisit) Jaymal Patel, MD

Hoefs, Jamie Rajasree Praturi, MD

Obuba, Joseph Edward Ajayl, MD Parkman, Sharade Paula Pollard-Thomas, MD

The Committee determined that the following protocol agreements do NOT meet the

provisions of O.C.G.A. 43-34-25. Lott, Jodi Jaymal Patal. MD

Madlock, Danielle Okah Anyokwu, MD

Nabritt, Terri Jose Artadi, MD

Nelson, Randall John Beaty, MD

Paulk, Carlas David Faulk, MD

Peterson, Gena Shroff, Manisha

Price, Catherine Jaymal Patel, MD

Smith, Daniel Jaymal Patel, MD

Snelling, Shakera Manisha Shroff, MD

Soles, Stanley Jaymal Patel, MD

Spivey, Villanueva John Beaty, MD

Stephens, Tammy Shahzad Hashmi, MD

Stidham, David Jaymal Paytel, MD

Protocols Approved

APRN Last APRN First Middle Delegating Physician Name

Adams Matthew Naser Humayun

Agomessou Ablavi Carla Bedford-Dixon

Aikens Malcolm John Lewis

Alferink Jessica Tonya Fordham

Allen Holly Edward Kang

Allen Krystal India Robinson

Ballard Monica Karla Booker

Banares Julie Zahidul Chowdhury

Barrett Kasie Sadiq Sohani

Bartoli Monika Francisco Echevarria-Santiago

Baumann Joni Henry Nygren

Beckett Davies Summer Christopher Edwards

Bell Maegan Najeeb Siddique

Branchetti Dana Premila Malhotra

Bright Retta Jeffrey Winston



10


Brisibe Modupeola Janet Bivens

Brockman Hailey Rajan Kapoor

Brown Patrick David Pursalle

Brown Jessica Ibrahim Quinones

Bruner Christina Philip Kimsey

Buggs Temeka Jerry Phillips

Carney Julie Ayman Fareed

Carter Kariba Shaila Day

Carter Yaquisha Elwyn Clark

Chhun Domineque India Robinson

Chong Hannah Kyoung Lee

Christmas Marcy Vincent Culpepper

Cote Wilma Odell Still

Cox Stephanie Michael Scott

Cox Sheryl Ian Furtado

Czarnecke Heather Gurpreet Ahluwalia

Davis Audra Cesar Figueroa

Davis Sharonda Rajan Kapoor

Desrosiers Myrlene Saman Ghaffari

Dirven Tamara Ganesha Perera

Dover Eileen Lynette Stewart

Driggers Dawn Shad Stormant

Ellers Julie Allen Solomon

Emory Rebecca Sonam Bhalla

Faison-Oyebanji Yulanda Maged Abdelmalik

Farhy Heather Palanisamy Rajasekaran

Fernandez Lindsay Arthur McCain

Fletcher Jamez Divya Gupta

Fomunung Grace Dawit Weldemichael

Ford Latasha Jose Cangiano

Forman Anna Bryan Wells

Fuller Ashley Jill Dickerson

Gaddis Funlola Lawrence Powell

Gallivan Kathryn Charles Cha

Gangwisch Christine Angela Falany



11


Gayden Andrea Judith Volcy

Georges Frantz Vera Tate

Gordon Sabina David Bryant

Green Stephanie Robert Miller

Griffith Megan Vinod Thourani

Haid Jeanne Derek Culnan

Hall Jocelyn William Burak

Harris Sarah Timothy Moore

Harrison William Sheila Best

Hart Rebecca Brad Goodman

Hawkins Chrystal Jennifer Francois

Heiges Alessandria Natalie Britt

Herrick Aleena John White Jr.

Hillmon-Scruggs Ebony Benjamin Bailon

Hodges Matthew Errol Graham

Holder Maria Kelly McCants

Holmes Taylor Giovanni Piovesana

Hood Marian Mitchell Wilson

Hosang Michelle James Namnoum

Hughes Leslie Teresa Bradford

Hunter Natalie Stephen Jarrard

Hurley Robin Michael Litrel

James Cindy Daren Wooten

Jolly Tammy Claudia Conde

Kelley Brandy Gurpreet Ahluwalia

Kelly Paul Izzeldin Abdalla, MD

Kemp Savannah Louellen Gurley

Kemp Savannah James McGowan

Kendrick Patricia Daniel Singleton

Knight Amber Richard Stevens

Kolovich Martina Gregory Kolovich

Kwee Mary Tam Nguyen

Leary Bridget Felix Sogade

Lee Knicole Jaxon Cox

Little Patrice Naima Cheema



12


Lumpkin Ashley Sung Cho

Malcolm Alexis Henry Nygren

Malstrom Stacey Nydia Bladwell

Martinez Angelisse Sherri Barton

Merriman Laura Issac Sved

Miller Jenifer Aaron Alizadeh

Miller Marci Trushnaa Patel

Minter Mary Valarie Manley

Monroe Cecily Syed Rizvi

Mooyin Candice Alton Greene

Morgan Carley Richard Bowers

Moss-Traore Gilda Susan Blank

Neal Olivia George Powell

Nunnally Ashley Joseph Hobbs

Ogun-Semore Olawunmi Asaf Aleem

Olson Sheryl Wayne Chiu

Opare-Addo Margaret Margaret Schutte

Patel Nishaben Paresh Thanki

Paulk Tina Lauren Hudak

Phillips Shelly Henry Purvis

Pington Robin Chinedu Hwere

Pittman Amber Ian Furtado

Pollard-Manigualt Denise James Thomsen

Price Jennifer Abby Abisogun

Reed Meghan Jemy McLane

Rushing Stephanie Francisco Echevarria-Santiago

Saint-Amand Beverly Cindy Freed

Saint-Amand Beverly Kurt Jacobson

Salimonu Janet Roberto Norniella

Scarborough Erica David Flowers

Schaaf Courtni Nora Tan-Ngo

Seaborn Chelsea Jonathan Nguyen

Shafer Kristi Lisa Ortenzi

Shaw Marissa Jeffrey Oyler

Smith Allison George Stickney



13


Smith Natacha Martin Johnson

Srickland Thomas David Shore

Stidham David Jaymal Patel

Taylor Leslie Leslie Taylor

Taylor Tania Licheng Tian

Toulon Gina Keith Michael

Toussaint Athara Tangela Atkinson

Troyer Peggy David Harvey

Tucker Kristin Ellen Courson

Turner Tiffanie Denis Morin

Tyus Brittney Darrell Surratt

Unogo Cindy Catherine Christie

Van Horn Rachel Jennifer Jones

Walker Jill David Lovejoy

Walton Candace Richard McIncrow

Warren Felecia Richard Cunnigham

White Julie Tam Nguyen

Williamson Trina David Flowers

Womble Taurus Mrunalee Mehta

Wood Miranda Bradley Morganstern

Yates Brittany Julian McClendon

Zmaj Andrea Lynette Wilson-Phillips

Any Old/New Business

Asked the staff to send a letter to Dr. Patel about the exemptions and number of NP’s he is

supervising.

PHYSICIAN ASSISTANT ADVISORY COMMITTEE

Dr. Antalis presented the Physician Assistant Committee report


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

PA

Supervising Physician

Benedict, Kathleen Molina, Adolfo

Catherwood-Bartholomew, Gwen Laskar, Sonjoy

Daker, Wesam Thankachan-Jacob, Arun



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Edenfield, Christopher Gard, Dwayne

Habte, Rebecca Ahmad, Rukhsana

Hughes, Sean Wolfe, Christopher

Jagun, Erica Bress, Joel

Metz, Rachel Hazel, Robert

Patel, Devina Thames, Todd

Schneider, Kyle Roepke, Thomas

Yarima, Salihu Solitario, John

Approve the following application for initial licensure with a supervising physician pending

additional information:

PA Supervising Physician

Joseph, Anish Warner, John

Approve the following application for initial licensure with a supervising physician pending

renewal of NCPAA Certification:


Rawlinson, Bryan Miller, Alan

Approve the following applications for initial licensure without a supervising physician:

PA

Almeida, Michelle

Aponte-Torres, Beatriz

Baggett, Bobbie

Beckmon-Forrester, Brittney

Black, Christina

Bos, Michelle

Bross, Morgan

Cheema, Jamshaid

Francois, Patrick

Hatcher, Jessica

Kwarteng, Sandra

Peterson, Elanor

Romanello, Tiffany

Webb, Julie



15

Advise the following to withdraw initial application without a supervising physician due to

underlying circumstances:

PA

DB

Approve the following applications for reinstatement with a supervising physician:


Advise the following to withdraw application for reinstatement without a supervising physician

application due to restricted license in other states:

PA

AEB

Approve the following Add/Change applications:


Abebe, Beniam Falconer, Walter

Alexander, David Hardee, Michael

Attawala, Rauha Patel, Nipun

Benz, William Williams, Robert

Bertrand, Lakiesha Butler, Caroline

Blair, Emory Sharif, Shan

Blessing, Lauren Mandalapu, Kamal

Bloodsaw-Scott, Lashonda Dairo, Dokun

Bloodsaw-Scott, Lashonda Amene, Philippa

Boyer, Derek Supple, Nichole

Bunt, Janice Bedell, Sidney

Byrd, Kelsey Prather, John

Cammon, Thomeshia Wood, Robert

Carstens, Nicholas Nygren, Henry

Cilimberg, Matthew Ki Wan, Kim

Cogburn, Rallie McCullough, Ricky

Coulter, Darrin Haddad, Sinan

Craig, Chanelle Naccarato, Sergio

Davis, Donica Abbott, John

Duval, Rosmary Katkoori, Devendar

Edwards, Roxanne Peng, Vincent

Erusiafe, Kevwe Buelvas, Raul

Erusiafe, Kevwe Schwartz, Stephen



16

Ferjuste, Fedlande Toro, Gyula

Florez, Joana Rubin, Tod

Florez, Joana Okanlawon, Olutoyin

Gist, Julian Okanlawon, Olutoyin

Godfrey, Angela Richey, Wayne

Grifis, Georgia Harding, Susan

Hall, Kevin Okanlawon, Olutoyin

Hall, Kevin Fabayo, Adesola

Hall, Kevin Beatty, James

Hammond, Karen Mohammad, Fawzi

Hartley, Krysta Srinagesh, Prasanna

Hass, Christopher Stirton, Jacob

Hayes, Ashley Ford, Alexcis

Heard, Matthew Wooley, Rahim

Hedden, Allison Nixon, Bruce

Hernandez, Andres Zeidan, Ronnie

Jamail, Brian Faile, George

Jennings, Ronald Claps, Charles

Johnston, Lucas Torres, Arturo

Johnston, Lucas Varias, Jon

King, Melanie Gilman, Cary

Koopal, William Dyer, Rupert

Lack, Kevin Collins, James

Layfield, William Price-Jackson, Christina

Lewis, Stephen Kang, Brandon

Li, Jianmei Patel, Gaurav

Little, Richard Glenn, Robert

Littlefield, Wayne Gray, Arthur

Lux, Naomi Jordan, William

Makin, Shannon Johnson, Joe

Marbury, William Howe, Danielle

McClure, Melissa Frederick, John

Melnik, Larissa Connell, Cymanthia

Mikronis, Zacharias Torres, Arturo

Montana, Armando Fields, Jayson

Morrison, James Ma, Christopher

Nelson, Suzanne Francis, Woody

Olansen, Nancy Kenning, Tyler

Page, Bradley Lee, Clay

Patel, Apexa Titlman, Robert

Perry-Davis, Carla Hwang, Lily

Pineda, Nicolai Smith, Luke



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Pineda, Nicolai Smith, Elizabeth

Rice, William Newfield, William

Robinson, Terry Hamilton, Joy

Roush, Andrew Black, Steven

Rush, Christa Ravi, Ajay

Schuler, Shelley Gray, Leslie

Schutz, Douglas Khaldoon, Al-Moosawi

Sedor, Gregory Bradley, Caitlin

Sharma, Amit Rogers, Ryan

Shinabarger, Andre Gilliam, Jessica

Snyder, Elizabeth Manu, Yaa

Snyder, Elizabeth Chai, Young

Sonders, Leslie Refai, Daniel

Stephenson, Julia Sridharan, Marandapalli

Stevens, Gregory Morris, Jonathan

Stevens, Gregory Cheever, Bryan

Stoker, John Burke, Michael

Stubbs, Karin Rubin, Tod

Thomas, Alexa Kim, David

Thomas, Omokayode Grube, Matthias

Toussaint, Eddy Sellers, Marty

Tucker, Kenya Barlatt, Crispin

Von Der Schulenburg, Amanda Page, Eugenia

Vu, Tram Whitmore, Morgan

Weaver, Adam Evans, Charles

Weaver, Adam Barrett, Alina

White, Blaise Torres, Arturo

Willauer, Eva Bapat, Amol

Williams, Gregory Armenia, Robin

Willoughby, Kenneth Jasper, Travis

Wood, Michael Black, Steven

Approve the following Additional Duty Request:

Misty Banknell, PA with – Dr. Mark Bonner

Injection of Dermal Fillers

Injections of Botox

Karen Hammond, PA with – Dr. Fawzi Mohammad

Insertion of Tunneled Central IV Access

Bibi Haniff, PA with – Dr. Stephen Frohwein

Stress Testing



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Tony Lynn Herring, PA with –Dr. Richard P. James

Injection of Botox

Performance of Chemical Peels

Injection of Dermal Fillers

Aubrie Mathewson, PA with – Dr. Steven Niergarth

Arthrocentesis of the Knee

Intra-Articular Injections of the Hip

Intra-Articular Injections of the Knee

Intra-Articular Injections of the Shoulder

Intra-Articular Injections of the Sacroiliac Joint

Intra-Articular Injections of the Carpometacarpal Joint

Lacey McLendon, PA with Dr. John Barton

Gastrojejunoostomy Tube Exchange

Liver Biopsy

Pleurx Insertion

Nephrastomy Tube Exchange

Marcus Parker, PA with Dr. Arthur McCain

Plueurx Placement

Fluid Aspiration

Liver Biopsy

Drain Placement

Image Guided Non-Vascular Tube Change/Replcement

Jennifer Vincent, PA with – Dr. John Layher

Cardiac Stress Testing

Request the following to submit 240 shadowing hours:

PA

TS

Other Business:

1. CAA business venture scope of practice inquiry. Full Board Review

2. Compose written guidelines for PA's licensed in Georgia who work in federal facilities

regarding the following:

- Add/Change requirements that differ when both the Supervising Physician and Physician

Assistant hold Georgia licenses.

- Statement or policy specifying we do not have jurisdiction over DEA requirements for both

Federal and non-Federally employed Physician Assistants in Georgia. PA Committee agreed

to provide guidelines.

COSMETIC LASER ADVISORY COMMITTEE



19

Dr. Gross presented the Cosmetic Laser Committee report as a motion and it carried

unanimously.


Approved the following for Assistant Laser Practitioner –

Tatiana Castillo

Katherine Canzoneri

Kyoung Ok Choi

Amy Coker

Victoria Dabbs

Lexi Giles

Heather Livingston

April Marcum

Megan Polichnowski

Approved the following for a reissue of Assistant Laser Practitioner –

Laura Hill

Stephanie Lawson

Peggy Mills

Approved the following for Senior Laser Practitioner –

Ragan Gaskin

RESPIRATORY CARE ADVISORY COMMITTEE

Dr. Dalton presented the Respiratory Care Committee report as a motion. The Board accepted

the report by unanimous vote.


Correspondence

1. The Committee proposed changes to the RCP rules and guidelines. Changes will be

presented to the Rules Committee for review next month.

2. The Committee denied requests for extensions of temporary licenses.

Reinstatements:

Dalis, Abigail- pending additional information

Dempsay, Jessica

Holt, Deanna- pending additional information

McCarthy, Michael

Pruitt, Latorie



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Temple, Kimberly

Walker, Devonie

Temporary:

Barber, Ryan

Benson, Noah

Edmond, Tiffany- pending additional information

Floyd, Angela

Gay, Kayla

Harris, Shekina

Jolly, Shacorea

Kelly, DeAngela

Lamar, Kendra

Morton, Dakota

Reese, Courtney

Wells, Tina

Full Licensure:

Carr, Ada

Dauphin, Betsy

DeVivo, Jennifer- pending additional information

Horner, Renee- pending additional information

Jenness, Vincent- pending additional information

Moneit, Marissa

Newell, Annis

Rosenhoover, Lauren

Soeun, Yien- pending additional information

Administrative Upgrades

1. Krishna Patel

2. Davarrio Worthy

3. Rhianon Mangan

4. Ashley N. Martin

5. Olivia Kile

6. Ashley Brooks

7. Melissa Moss

8. Timothy Harris

9. Kimalyn Scott

10. Emmalee Albritton

11. Casey Mimbs

12. Raela Meadows



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13. Chaston Weaver

14. Jenna Foster

15. Jennifer Harris

16. Rifath Rashid

17. Hannah Faulkner

18. Deborah Plaines

19. Erin Sterling

20. Ann Marie Do

21. Jessica Davila

22. Rachel Harris

23. Patrick Mitchell

24. Melat Kebede

25. Isabel Diaz-Guerrero

26. Samuel Mathis

27. Brandi Jones

28. Mary Gibbs

PERFUSION ADVISORY COMMITTEE

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

report by unanimous vote.


Approved the following applications for Initial Perfusion licensure:

Yana Ivasko

Daniel Rodriguez

ACUPUNCTURE ADVISORY COMMITTEE

Mr. Law presented the Acupuncture Advisory Committee report as a motion. The Board

accepted the report by unanimous vote.


Accepted the quarterly reports for the following:

Terrence Park

Invite JHL for an interview with the Committee and to provide a complete documented work

history since completion of education.

Other Business:



22

Board staff to reply to email from Susan O’Neill to notify her that medical records for

acupuncture patients must be maintained for ten (10) years.

PAIN MANAGEMENT COMMITTEE

Dr. Simmons presented the Pain Management Committee report as a motion. The Board

accepted the report by unanimous vote.


Application Pain Clinic Name

547601 Specialty Spine and Pain, P.C.- Buford

Reinstatement License # 155 Georgia Pain and Wellness- Atlanta

Approved pending $10,000 fine for unlicensed practice

License # 155 Georgia Pain and Wellness- Atlanta

Request to Change Name

The Committee approved the following applications that were Administratively Approved

License # Pain Clinic Name

269 Ellis Pain Center-Watkinsville

Add Practicing Physician, Christopher Sellars

Delete Practicing Physician, Terrance Hughes

License # Pain Clinic Name

224 Harbin Clinic, LLC-Rome

Add Physician Assistant, William Johnson

Delete APRN, Serena Moss

364, 485 Neurological Spine and Pain

Add APRN, Kelli Hendley

118 Center for Spine and Pain

Add APRN, Kasie Barrett

116 Georgia Pain and Spine Care

Add Practicing Physician, Ashna Parti

520 Serenity Spine Center-Springfield



23

Add Physician Assistant, Kayla Hill

326 Alliance Spine and Pain Centers

Delete Practicing Physician, Myrlynn Delille

279 The Nexus Pain Center of Columbus

Delete APRN, Magenia Janney

Delete APRN, Christopher Garner

Revise Hours

416,418 Alliance Spine and Pain Centers

Delete Practicing Physician, Ashna Parti


Delete Practicing Physician, Myrlynn Delille


Delete Practicing Physician, Shahnaz Bari

234,235,451,

pending F547601 Specialty Spine and Pain, PC

Add APRN, Emily Brooks

Other Business:

1. Should the Medical Board charge a fee to add APRN’s who fall under rule OCGA 43-34-

23, but do not have protocol agreements with delegating physician(s) nor prescribe

controlled substances?

• The Committee recommended board staff continue with current policy for

APRN’s.

2. The Add, Delete, Revise Pain Clinic application is 6 pages. The last page is the Personnel

Certification Form (Background Check info). If an applicant is deleting a physician, does

this page need to be included?

• The Committee recommended board staff revise and update the Add, Delete,

Revise Pain Clinic application.

GENETIC COUNSELORS ADVISORY COMMITTEE

Dr. Deloach presented the Genetic Counselors Advisory Committee report.




24

1. The Committee reviewed and discussed some questions presented by applicants.

2. The Committee agreed that the meeting time for future meetings will be at 6:00p.m.

3. The Committee reviewed and discussed the following question presented by an applicant

and need the full Board’s input.

Question: I'm not currently employed as a genetic counselor, but I will need to provide

genetic counseling services as part of my job. My direct supervisor is not a physician.

Should I leave the physician's information blank on the reference form? Where should

my supervisor sign if she is not a physician?

Board staff updated the reference form for the signature area to include physician or

certified genetic counselor.

ORTHOTIST & PROSTHETIST ADVISORY COMMITTEE

Dr. DeLoach presented the Orthotist & Prosthetist Advisory Committee report.


Approved the following applications:

Scott Annis – Initial Dual O&P (Mr. Walker recused.)

Kori Campbell – Upgrade to Dual O&P

LAW ENFORCEMENT ADVISORY REPORT

Phyllis Douglas, Legal Services Officer, presented the report as a motion. Dr. Marshall

seconded. The Board accept the report by unanimous vote.

1. M.K., MD; A.A., MD – Approved to release the records, redact confidential information

2. 20191025 – Approved to release the records

3. A.O., MD – Approved to release the records

4. L.F., MD - A.M., APRN – Approved to release public information only

5. 20162046 – Denied request to release the files; request must come directly from agency

WELLNESS COMMITTEE

Dr. Harbin presented the Wellness Committee report as a motion and Dr. Simmons seconded.

The Board accepted the report by unanimous vote:

a. PHP report



25

b. Non-Interview Matters:

a. 20200426 – Review request for second opinion after voluntary release from PHP.

Recommendation: If failure to report to GA PHP, agree to interim

suspension/summary suspension due to evaluation.

b. 20200519 – Review self-report prescribing complaint and discuss with GA PHP

Recommendation: Follow guidelines for GA PHP.

c. Interview Matters:

a. 20171205 –

Recommendation: Agreed to follow recommendations from treating physician,

and submission of advocacy letters from therapist and primary care doctor.

b. C.R., M.D. – Application for reinstatement. Application responses required

additional information and follow-up. Recommendation: Accept Licensure

recommendation.

INVESTIGATIVE INTERVIEW REPORT

Dr. Marshall presented the Investigative Interview report as a motion, and was seconded by Dr.

Retterbush. The Board accepted the report by unanimous vote.

The Board took the following actions.

20192069 AGNOH 20192425 LOC

20181575 TABLE 20190551 LOC

20191888 CLOSE 20192014 PEER

20192172 CLOSE

INVESTIGATIVE COMMITTEE

The Investigative Committee report was presented as a motion by Dr. Retterbush and was

seconded by Dr. Harbin. The Board accepted the report by unanimous vote.

The Board took the following actions.

Close:

20150119 20150910 20161915 20162402 20171480 20172007

20181306 20182210 20190072 20190140 20190269 20191703

20191827 20191911 20192000 20192121 20192300 20192335



26

20192383 20192421 20192434 20192477 20192482 20192483

20192511 20192557 20192558 20192559 20192588 20192594

20192602 20192617 20200043 20200045 20200084 20200106

20200141 20200142 20200157 20200161 20200165 20200194

20200201 20200222 20200249 20200261 20200262 20200265

20200266 20200267 20200273 20200276 20200280 20200293

20200298 20200300 20200309 20200343 20200429 20200438

20200443 20200491 20200518 20200534 20200574

Close with Letter of Concern:

20171385 20181343 20181760 20190455 20191839 20191940

20192260 20192392 20192465 20192498 20192514 20192516

20192517 20200051 20200085 20200274 20200315 20200579

Invite for Investigative Interview:

20170011 20190853 20192138 20192200 20192509 20200376

20200506

Further Investigation:

20172321 20180067 20190380 20192412 20200284

Table

20191934 20192353 20192544 20200268

Attorney General’s Office

20160160 20200474 20181187 20182263 20160061

Peer Review

20181856

OMPE

20190560 20190598



27

INITIAL COMPLAINT EVALUATIONS The Board approved the following recommendations.

20200537 20200557 20200569 20200571 20200583 20200584

20200585 20200586 20200587 20200589 20200592 20200593

20200594 50500595 20200603 20200604 20200612 20200615

20200617 20200654 20200676 20200674 20200682 20200684

RECUSALS DeLoach 20182210

Marshall 20200141

There being no further business, motion Dr. Retterbush, seconded Dr. Weil voted to adjourn the

meeting at 4:04pm.

__________________________________ _____________________________________

Gretchen Collins, MD LaSharn Hughes, MBA

Chairperson Executive Director

Recorded by:

_______________________________________________

Phyllis White, Executive Assistant

georgia composite medical board minutes of the january 9

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