georgia composite medical board minutes of the july 11

Georgia Composite Medical Board

Minutes of the July 11, 2019 Meeting

1

The Georgia Composite Medical Board (GCMB) held its regular meeting on July 11, 2019, at 2

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

Board members present:

John S. Antalis, MD

Gretchen Collins, MD

Charmian Faucher, PA (ex-officio)

Michael Fowler, Sr., CFSP

Alexander S. Gross, MD

Thomas Harbin, MD

Rob Law, CFA

Matthew Norman, MD

Andrew Reisman, MD

Joe Sam Robinson, MD

Barby Simmons, DO

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

Jonathan McGehee, Interim Director of Investigation

Phyllis White, Operations Manager

Latisha Bias, Enforcement Lead

Tara Williams, Financial Manager

Board members absent:

E. Dan DeLoach, MD

David Retterbush, MD

Richard Weil, MD

CALL TO ORDER

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

AGENDA AND MINUTES

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

July 11, 2019 meeting. The motion carried unanimously.

Dr. Harbin made a motion to approve the minutes of the June 13, 2019 meeting. Mr. Fowler

seconded the motion and it carried unanimously.

WELCOME TO NEW BOARD MEMBER

The Board members welcomed Dr. Dalton to the Board. Dr. Dalton gave a summary of her

background.

Chair’s Report

Dr. Collins thanked the Board members for their vote of confidence in her leading the Board.

She mentioned that the Committee assignments were available and if there were any changes,

please let Ms. Hughes know. She discussed the new format for the Board agenda, which will

allow open session during the morning hours and afternoon would be closed. This is to help

accommodate the guests that are there for Rules Committee and open session items. She

discussed board meeting etiquette.



2

EXECUTIVE DIRECTOR’S REPORT

Ms. Hughes made the following report:

1. FYI – AJC Article and PCOM South GA Ribbon Cutting.

2. FYI – Article “The Perilous Blessings of Opioids”

3. FYI – FSMB: Report Surveying Digital Credentials in Healthcare Michael Hyde –

Corporate Practice of Medicine.

4. Assistant Physician Task Force from MAG – seeking the Board’s support of possible

legislation. The Board tabled the discussion for additional information.

5. HB 228 Premarital education providers – The Medical Board’s law is in the legislation.

The Board will post the flyer on the Board’s website and put a notification in the

newsletter.

PUBLIC OUTREACH COMMITTEE

Mr. Law presented an update on the complaint forms and will send out the revised form to the

members. He also mentioned that he was reviewing the new format for the Board’s new website.

RULES COMMITTEE REPORT

Dr. Gross presented the Rules Committee Report.

The Board voted to send the following Rules to the Office of the Attorney General for review

and approval prior to posting:

Rule 360-2-.01 Requirements for Licensure

Rule 360-2-.14 Requirements for Approval of International Medical

Schools.

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

Rule Chapter 360-28 Physician Profiles

HB 166 - Rule Chapter 360-40 Genetic Counselors

CLOSED SESSION

Dr. Gross motioned seconded by Dr. Antalis 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. Harbin submitted a motion, seconded by Dr. Reisman and motion carried to accept the report

and the following orders:

Andre Williams, MD

Gregory Wilets, MD



3

RECESS

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

RECONVENE

Dr. Collins reconvened the meeting at 2:10 p.m.

APPEARANCE BEFORE THE BOARD

Sook Sung An-Kil, Applicant for Acupuncturist, requested an appearance before the Board to

discuss her licensure application. Ms. An-Kil gave a summary of her history and background.

The Board members asked questions. Ms. An-Kil responded. Dr. Collins told Ms. An-Kil the

Board would table her request until she provides additional information.

Motion Dr. Gross, seconded Mr. Law to license Ms. An-Kil with terms and conditions.

LICENSURE COMMITTEE

Dr. Gross presented the Licensure Committee Report:

The Board took the following actions:

Applications Not Approved

SB Cancelled interview

IS Clinical Skills Examination

RL Interview

JM Interview

GS RNST with terms and conditions

EL Clinical Skills Examination or approved for a VIM license

AK Clinical Skills Examination: ABP MOC examination is also acceptable

JV Table

SV Table

AE Table

MS Table

JD License with terms and conditions

AV Uphold previous decision for Clinical Skills Examination or allow to withdraw

JB Uphold previous decision for Clinical Skills Examination or allow to withdraw

Applications Approved for Licensure

GS RNST with terms and conditions

Khoury, Norma Approve Educational Training Certificate

Parrilla, Gustavo Approve Institutional License

Vizzeri, Gianmarco Approve Institutional License

Waqas, Ahmed Approve RTP license



4

Physicians approved for Licensure

Name License Number

Kadchhud, Anushree 83477

Sandhu, Jasdeep 83478

Younus, Rida M 83479

Lee, Kristofferson 83480

Ertel, Nathan 83481

Bedder, Marshall 83482

De Simone, Laura M 83483

Shirk, Arianna M 83484

Spruell, Christopher 83485

Smith, Kevin D 83486

Parvus-Teichmann, Chad C 83487

Shah, Rakhee H 83488

Sternberg, Daniel S 83489

Stanback, Camille F 83490

Shah, Anish 83491

Simons, John P 83492

Albert, Brandee 83493

Barnes, Richard T 83494

Boateng, Frank 83495

Bradley, Jeffrey 83496

Forsthoefel, Eric M 83497

Carrasco Abinader, Leonel E 83498

Panwala, Apurva A 83499

Chae, Kyung Ai 83500

Patwardhan, Sanjay C 83501

Cho, Joo 83502

Zendehrouh, Pedram 83503

Chowdhry, Tayseer H 83504

Lee, Jessica M 83505

Krishnan, Meghna 83506

Coates, Charrelle 83507

Yarnall, James N 83508

Nasworthy, Mandy W 83509

Curley, Bridget 83510

Prahash, Arun 83511

Prior, David 83512



5

Yang, Xiaoyun I 83513

Pradhan, Dinesh 83514

Veeramachaneni, Hima 83515

Daley, Nicholas C 83516

Potthoff, Troy L 83517

Migdal, Victoria L, Victoria 83518

Mcpherson, Anthony A 83519

Vu, Lan N 83520

Patel, Khilen B 83521

Velam, Venkatabharathi 83522

Prause, Christopher A 83523

Vega, Maria J 83524

Vo, Bryan 83525

Mayer, Suman 83526

Tumminello, Katherine C 83527

Marshall, Gordon P 83528

Taylor, Robin 83529

Mel, Lin 83530

Tuttle, Mitch C 83531

Patel, Priya 83532

Rodriguez Rosa, Alan F 83533

Salau, Muskinni O 83534

Rowley-Herron, Jetuan L 83535

Ravenscroft, Jenny 83536

Kelley, Russell P 83537

Julien, Matheau A 83538

Robbs, Keyasha B 83539

Reddy, Vineet 83540

Seymour, Andrew 83541

Sprouse, Larry R 83542

Stubbs, Dawana L 83543

Sheelvanth, Hema V 83544

Rahman, Shahnaz Y 83545

Su, Andres W 83546

Sandhu, Diya G 83547

Short, Heather L 83548

Simon, Howard J 83549

Singh, Vipul 83550

Schwartz, Andrew L 83552

Williams, Justin K 83553

Baker, Chandra M 83554



6

Hoxha, Avjola 83555

Goldring, Sandra Y 83556

Fiedorek, Michael C 83557

Fordham, Kimberly M 83558

Klenk, Elizabeth E 83559

Hernandez, Jamille 83560

Gulati, Prem K 83561

Jean-Louis, Christopher J 83562

Gharir, Talal M 83563

Nano, Olger 83564

Goss, David A, Jr. 83565

Steverson, Rebekah A 83566

Karsan, Nikunj K 83567

Douglass, Travis A 83568

Marthambadi, Bhargav S 83569

Hartley, William C 83570

Adekunle, Olufunsho 83571

Antola-Lardizabal, Carla 83572

Kaplan, Carl A 83573

Boucher, Dulce E 83574

Kappel, Justin 83575

Cerny, Matthew J, Jr. 83576

Chaffin, Amanda C 83577

Chesser, Keith 83578

Cooper, Jacinta E 83579

Del Rio Rios, Jorge A 83580

Derusso, Gary, Ii 83581

Dhulipala, Sravan, Sravan Dhu 83582

Dobry, Ann 83583

Dziuba, Kayla K 83584

Foster, Bradley S 83585

Kirkpatrick, Jacob A 83586

Gupta, Vikas 83587

Jackson, Shari M 83588

Herbert, Steven 83589

Freetage, Lori M 83590

Houlis, Nicholas 83591

Grossman, Julia 83592

Ferro, Adam 83593

Ellis, Justin K 83594

Hormozdi, Bahram 83595



7

Khoury, Chaouki 83596

Gaddikeri, Santhosh 83597

Riordan, Heather R 83598

Godfrey, Diana 83599

Golan, Elan J 83600

Furtado, Ian 83601

Estakhri, Hadi 83602

Ghiassi, Courtney A 83603

Whang, Jeremy 83604

Stokes, Claire L 83605

Rice, Abraham C 83606

Walker, Wilson T 83607

Saah, Elna N 83608

Yeganeh, Vahid 83609

Rutherford, Keviene W 83610

Gerrity, Dianne T 83611

Lawoyin, Lajide R 83612

Lehrman, Craig R 83613

Louden, Philip C 83614

Mcalister, Sean J 83615

Mccloskey, Pamela K 83616

Mcdonnell, Meagan R 83617

Mckenzie, Mark M 83618

Miller, Serena N 83619

Montoya, Belinda 83620

Morgan, Robert A 83621

Nelson, James A, Jr 83622

Nusbaum, Robert C 83623

Okarter, Ned 83624

Onyeuku, Nasarachi 83625

Patel, Maulikkumar G 83626

Pickett, Meredith L 83627

Ping, Zheng 83628

Pranckun, Joel J 83629

Chihade, Deena 83630

Szymanski, Jesse P 83631

Shahsavari, Adam, Adam 83632

Whitted, Ryan 83633

Walsh, David 83634

Vlahu, Tedi 83635

Yanbeiy, Zeina A 83636



8

Zacks, Rachael 83637

Tatum, Randi 83638

Shatil, Ben S 83639

Scott, Sylvester M 83640

Adams, Richard 83641

Borrero-Mendoza, Andres 83642

Chand, Nikita 83643

Burns, Christopher 83644

Borte, Bernandette 83645

Katzman, Daniel A 83646

Forrest, Richard T 83647

Hickey, Brittany N 83648

Herman, Richard A 83649

Pappachen, Stephen 83650

Villo, Lauren E 83651

Aamer, Muhammad 83652

Baez, Amado A 83653

Desai, Shivam 83654

Dharmar, Logesh 83655

Brumfield, Jessica 83656

Nasir, Aqsa 83657

Medeiros Da Frota Ribeiro, Carolina 83658

Mansoori, Parisa 83659

Radhakrishnan, Sri Jegan 83660

Richardson, Vanessa N 83661

Rodriguez Hernandez, Janice 83662

Shah, Qaisar A 83663

Sabayon, Muhie Dean W 83664

Sirmon, Carie Ann F 83665

Damania, Rahul 83666

Browne, Brendan 83667

Deo, Sheetal R 83668

Francis, Dailia B 83669

Singleton, Rodmond 83670

Wahib, Samir A 83671

Ulualp, Mehmet K 83672

Patil, Allamprabhu S 83673

Herz, Daniel B 83674

Ayyaz, Muhammad 83675

Giebler, Antasia 83676

Mckalip, David 83677



9

Cameron, Robert 83678

Evans, Kendrix J 83679

Dorce, Jean 83680

Fine, Bryan R 83681

Mathis, David M 83682

Mcgriff, Michael A 83683

Jasser, Joseph 83684

Taglienti, Jenna L 83685

Thakarar, Rishi 83686

Tiwary, Anurag D 83687

Urgiles Alvarado, Susana C 83688

Seebach, Jeff 83689

Shetty, Safal 83690

Yadav, Pradeep K 83691

Young, Marisa R 83692

Thomas, Ronishia D 83693

Serban, Valeria 83694

Thomas, Sarah E 83695

Zmaj, Paul M 83696

Honarpisheh, Hedieh 83697

Kruse, Kristina L 83698

Forte, Jasmine C 83699

Hayden, Kyle B 83700

Haider, Janelle M 83701

Jackson, Eric 83702

Jakubowski, Robert 83703

Kruk, Kelly M 83704

Grines, Cindy L 83705

Lall, Niel U 83706

Langley, Michael J 83707

Massengill, Travis 83708

Meyyazhagan, Kanakadurga 83709

Mihalik, Jennifer E 83710

Mirza, Omer M 83711

Mofunanya, Cynthia 83712

Mojumder, Deb K 83713

Nepal, Shaili 83714

Patel, Dhaval P 83715

Prestia, Brett M 83716

Annex, Brian 83717

Fiaz, Bilal 83718



10

Jean-Charles, Kensy 83719

Hew, Michael 83720

Hagopian, Brandon C 83721

Estronza, Nordeli 83722

Withdrawn Applications

ADB

NURSE PROTOCOL COMMITTEE Dr. Gross presented the Nurse Protocol Committee report as a motion. The Board accepted the

report by unanimous vote.


Other Business

1 Eva Johnson, asked if a NP employed in a clinic can place lab orders and call patients to discuss

any changes to medication. Approved

2 Omega Reid, asked if a physician outside the 50 miles radios can be employed to supervised or

act as a delegating physician. Denied an exception cannot be granted since it is the law.

3 Jean Philippe, requested a waiver to allow her to have additional FNPs. Denied, this is a law; an

exception cannot be granted.

4 Avi Bahr, MD, if I have a clinic in Macon can I supervise a NP thru telemedicine in Moultrie.

Approved

5 Emily Gruber – Can a Pediatric Nurse Practitioner treat adult dermatology via telemedicine.

Approved (up to 21 yrs.) Must follow telemedicine rules.

6. Approved the following APRNs for practice through electronic means

a. Sharon Haggerty Alan Brown, MD

b. Amy Carter Barry Iguobadia, MD

c. Stephanie Lee Burris Christopher Inhulsen, MD

d. Robert C. Garrett, Jr. Christopher Inhulsen, MD

e. Julianne Johnson Richard Chase, DO

f. Karen Hatten Richard Chase, DO

g. Lauren B. Eschmann Richard Chase, DO

h. Tammy Duncan Richard Chase, DO

i. Care Connect Health -Eight letters total - Approved

7. Karen Deal – Approved to pronounce; cannot sign death certificate.

8. Approved Form C – Laquisha Hubbard – Dr. Mehta

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

O.C.C.A. 43-34-25. Avery, Courtney Jennifer Duke

Birdsong, Emily George Stefanis

Bruner, Laurence Eroll Duncan

Bundy, Madeline Fonda Martin



11

Burton, Yotta Kayln Lane

Cavazos, Sara Patrick Meloy

Howard, Nashanuna - Revisit John Beaty

Hruby, Sarah Daniel Kommel

Jewell, Lisa Ingrid Bloom

Johnicans, Tamika Aigul Guilmanova

LaPointe, Jodean Jayanthi Srinivashiah

Marswell, Kathy Sol Jacobs

Mathis, Kimberly Maribelle Verdiales

McGaha, Delanie Jesse Petrea

McIntire, Shalundrah Sofia Munir

Merritt, Marcie Jeffery Winge

Monsrud, Jennifer Philip Ploska

Moore, Audra Robert Burton

Omodele, Sarah Bethany Davis

Poage, Rachel Laura Bleekrode

Regis, Sonja Kathleen Butt

Walker, Jill Henry Davis

Woodley, Travis Aman Kakkar

Ziegler, Elizabeth Barbara Jones

DeRosa, Caroline Reemon Bishara

Hartfield, Satoya Anne Cowan

Hitchcock, Robin Jonathan Ratcliff

Jones, Dustin Christopher Robinson

Moss-Traore, Gilda Aigul Guilmanova

Scott, Notoya John Ouderkirk

Smith, Rachel Gary Daniel

Watts, Jason Henry Eugenid

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

provisions of O.C.G.A. 43-34-25. White, Keena Lewis Petrea

The following protocol agreements were presented and are pending additional

information: Gonzales, Laura - Revisit Jim John

Ditta-Donahue, Gina Marc Yune

Ellis, Joye David Banks

Gober, Jennifer Anne Cowan

Hampton, Amber Amit Tibrewala

Harrelson, Christina Pratik Mehta

Protocols Administratively Reviewed/Approved that meet the provisions of OCGA 43-34-25:

Adeboye Nimota Felicia Rhaney

Aikens Malcolm Arthur Yancey

Alibey Ariel Scott Henderson

Alle Anna Raymond Easley



12

Amoako Pearl Frank Curvin

Andersen Elizabeth Lijo Simpson

Anderson June Deborah Chambers

Anderson Justin Mark Wood

Anyaoha Forstina Harry Lightfoot

Anyu-Chita Weks Kirpich Joseph

Armand Jean Samuel Lorenzo

Barber Missy Marisa Chavez

Battle Juanita Stacia Dzikuni

Behrend Rachel Adolfo Molina

Bhika Nisha James Yost

Bisso Brandon Hardik Parekh

Bolger Angela Miles Mason

Bond Joel Alex Kalapila

Boring Tiffany David Alvarez

Bradshaw Shelia Mark Wolozin

Braley Catherine Bradley Sumrall

Browne Ama Thomas DeMarco

Browne Ama Thomas DeMarco

Bruner, Jr Lawrence Eroll Duncan

Bundotich Sylvia Tracy Barefield

Bundy Madeline Fonda Martin

Burgess Tashnie David Hocker

Butts Tara Perry Hearn

Chapel Melissa Tracy Barefield

Chaphe Tina Nima Ghasemzadeh

Chong Christine Woun Hui Seok

Clevenger Zachary Ankit Patel

Coar Jaekea Tameka Byrd

Crittenden Darlene Mariha Feliciano

Croft Lyndy Christina Adams

Dale Crystal Jeh Wei Cheng

Daniels E'Toyus Arthur Yancey

Dao Linh Tracy Barefield

Davenport Myrtle Darrell Murray

David Charlotte Arun Mohan

David Bradley Lester Littell

Degoh Rosemary Ekei Tanifym

Dukes Alvon Timothy Shelton

Eke Chibuzor Tiffany Parks

Ernest Michelle Gregory Parker



13

Foley Kathryn William Powell

Fortune Maima Stefan Routt

Fuller Chevita Jennifer Evans

Gamble Marissa Phillip Gray

Gaston Valerie Andrea Lambert

Gavette Aimee Joseph Novak

Geiger Jennifer Jeh Wei Cheng

Gephart Rebecca David Alvarez

Goad Jordan Rohit Khanna

Griffith E. Grace Lindsay Fowler

Hakala Erika Brad Weselman

Hale Ashley Carols Martinez

Hall Heather William Knopf

Haslem Natalie Golden Barnett

Hastings Judy Jaiye Conner

Haupt Sandra Laurence Beer

Head Ashley Lawrence Beer

Heard Felicia Rani Chebrolu

Hinton Denise Angampally Rajeev

Hobbs A. Shai Lewis Collins

Holley Nelda Amar Mohan

Hong Michelle Robert Frantz

House Christal Jameson Estes

Howard Nashanuna John Beaty

Howard Lorri Sofia Munir

Hruby Sarah Daniel Kommel

Huenink Kisa Thomas Gearhard

Jabaley Teresa Laneau Hayes

Jeffrey-

Mcann Clovalyn Yong Park

Jewell Lisa Ingrid Bloom

Johnnicans Tamika Aigul Guilmanova

Johnson Eva Mahmoud Abdou

Jones Janna Lina Millan

Jurgensen Katharine Michael Fry

Keeley Sara Islam Eharawy

Knowles Amanda Arthur Yancey

LaHaie Elizabeth Rouba Garro

Lantaff Tracy Peter Wrobel



14

Lashley Steven Kyle Jones

Leech Christopher Elia Abboud

Litton Jessica Ryan Whitney

Looney Gina Subodh Agrawal

Love Elizabeth Ioannis Parastatidis

Madden Joann Sarita Sharma

Maliwa Branderly Stephen Broomes

Marbut Holly Eroll Duncan

Mason Patricia Michele Mitchell

McCray Simone Wesley Leigh

McDaniel Erica Daniel Williams

McGaha Delaine Lewis Petrea

McIntire Shalundrah Sofia Munir

McIntosh Marie Joyce Kim

McPeak Justin Gregory Smith

Medley Catherine Kenneth Kokko

Moore Lashanda Rani Chebrolu

Moore Sharea Shaila Day

Moroz Denise Petrenia Davis-Jenkins

Morris Delaney George Lyon

Naidu Gopika Islam Eltarawy

Omodele Sarah Bethany Davis

Overton Amanda Bernard Kim

Parker Caylin Marianne Yee

Parker Reglindis Rukhsana Ahmad

Patrick Aubrie Tracy Barefield

Pearson Anela Jeh Cheng

Peterson Berry Sara Goza

Phillips Joseph Sebastian Stanciu

Poage Rachel Laura Bleekrode

Prayter Susan Brett Prylinski

Primas Brittany Crystal Owens

Privett Samantha Laura Divoky

Queen Amy John Hoyt

Ragan Carson Shelley Allen

Regis Sonja Kathleen Butt

Reinhardt Jessica Mark Crick

Rhodes Kristen Nima Ghasemzadeh



15

Ridgeway Sarah Brian Maziarz

Robertson Shelley Mahmoud Abdou

Robinson Katrina George Wray, III

Scott Donna Vamsi Kota

Setzer Ansleigh Patel Ankit

Shehee Tina Eroll Duncan

Shelton Tracey Ioannis Parastatidis

Shrewsbury Julie Joseph Bishop

Simpson Ashley Ankit Patel

Simpson Utopia Taslima Bhuiyan

Smith Robin Ambreen Mardhani

Smith LaTanya Musharaf Mamin

Sostre Maria William Powell

Sowole Racheal Bamidele Adeyemo

Steele Katherine Ambreen Mardhani

Tarver Patricia Igor DeCastro

Thomas Carolina William Mills

Thomas Genver Tracy Barefield

Thomason Amy Kathryn Dudas

Thompson Karen Duriel Gray

Trent Amy Jeh Cheng

Turk Christy Veerappan Subramaniyam

Underwood Jo Candace Vaughn

VanBuul Carol Harold Jackson

VanNess Kimberly Mark Hendricks

Verme Mirose Karen Harris-Moore

Walker Annie Shivakanth Burugu

Walker Jill Henry Davis

Ward Denise Alan Sanders

Watry Lauren Brittany Andry

Wells Tiffany Brett Prylinski

Whalen Stacey Freddy Gaton

Whaley Keren Malini Reddy

Whitener Zachary Charles Baggett

Whitley Amy Stanley Sinclair

Williams Margaret Brian Bourgeois

Woodley Travis Aman Kakkar

Woolwine Megan Stephanie Chapman

Woolwine Megan William Shivers



16

Yi Chai Islam Eltarawy

Ziegler Elizabeth Barbara Joy

Zielinski Jordan Crystal Hood

Zimmerman Ashley Jonathan Kerrick

Zziwa Jackie Eroll Duncan

The Committee discussed changes to the APRN protocol, Form C, and APRN FAQ section; and asked

the staff to make changes.

PHYSICIAN ASSISTANT COMMITTEE

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

the report as amended by unanimous vote.


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

PA Supervising Physician

Alexander, LeAllen Swofford, Williams

Allen, Thomas Suh, Daniel

Alpern, Hallie Alkhatib, Mhd. Anas

Cook, Brandon Asrael, David

Ferrier, Carleigh Goldstein, Jay

Ferguson, Erin Sullivan, Michael

Giustra, Caroline Wright, Sylvia

Grady, Sarah Chao, John

Harris, David Johnston, Richard

Koenders, Kevin Nordsiek, Michael

Lee, Cassidy El-Amin, Saadiq

Meagher, Ann Patrick Nahai, Farzad

Richardson, Keifer Harper, Rene

Trieu, Anh Mally, Abhijith

Yosua, Kira Tomus, Sabin

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

PA

Anderson, Michael

Ball, Kristen

Baron, Jared

Boyd, Brenton

Douglas, Donald

Duval, Rosmary

Ellis, Claudia

Figella, Katherine

Harold, Chrisitian



17

Healy, Logan

Heard, Elizabeth

Johnson, Martin

Joiner, Robert

Jones, Caroline

Marshall, Courtney

Mikhaylova, Arnella

Rawson, Shaye

Reid, Courtney

Tran, Phong

Velani, Zeshan

Vieira, Daniel

Retroactively Approve the following application for initial licensure with a supervising physician:


Childs, Melissa

Thomas, Richard

Approve the following Add/Change applications:


Aaron, Elizabeth Bullock, Lenora

Alarcon, Ramon Resnick, Stephanie

Arthur, Michael Murray, Paul

Ashley, Amanda Leewood, Charles

Ball, Sarah Langford, David

Bashir, Noman Hollifield, David

Batson, Jordan Fuqua, William

Birn, Jason Kelly, Sean

Bittinger, Catherine Ashutosh, Rao

Boatright, Phillip Carrington, Helen

Boston, Jessica Walpert, Kimberly

Bowser, Bradley Hall, David

Bryan, Mary Farber, Bobbi

Childress, Shawn Kuntz, Richard

Ciemniecki, Elizabeth Corujo-Rodriguez, Andrea

Clayton, Alexis Tugbiyele, Folusho

Clayton, Alexis Raybon, Robert

Clayton, Tyger Polak, John

Clayton, Tyger Chandrasekaran, Neeraja

Davis, Anthony Wilfong, Walter

Davis, Bartlett Jones, Kyle

Dinkins, Alton Lehman, Eric



18

Downs, Emily Crim, William

Downs, Emily Kindregan, Patrick

Edwards, Meghan Birenberg, Brad

Elstad, Adrienne Federico, Thomas

Foster, Beverly Kuntz, Richard

Franklin, Michael Howe, Maria

Galletta, Esther Wheelis, Michael

Garland, Ricky Adjei, Lawrence

Griffin, Megan Goodson, Brinkley

Hall, Heather Brown, Gavin

Harper, Marron Williams, Shawn

Hawkins, James Mathews, Christopher

Hawn, Thomas Patel, Piyushkumar

Jackson, Rebecca Markham, David

Jones, Aleysia Mcphillips, Kristin

King, Jamison Langford, David

Kopel, Mark Kuntz, Richard

Kumar, Namita Rabb, Daniel

Lamberth, Skyler Meza, Yenney

Lamberth, Skyler George, Vijia

Lee, Emily Weinen, Paul

Legros, Estelle Patel, Jitesh

Lindquist, Ronald Sinnott, James

Mabry, Adam Lemon, Michael

Mack, Dorothy Brown, Russell

Mathis, Byron Weinen, Paul

Mcdowell, Ashley Patel, Amar

Mcmanus, Emily Kuntz, Richard

Metayer, Stephanie Lipscomb, Michael

Miles, Jerrica Andrews, Faith

Neil, Priscila Chebrolu, Rani

Neil, Priscila Vernekar, Shipla

Newman, Eric Collins, James

Nguyen, Maragaret Mills, Jefferey

Oduah, Adanma Akintayo, Adebowale

Oduah, Adanma Little, Kevin

Osborne, Lauren Divvela, Satyanarayana

Parker, Taylor Devine, Robert

Perdue, Scott Jones, Jeffry

Piestrak, Donald Oshinowo, Abayomi

Pipkin, Amanda Garrett, Joshua

Poston, Rachel Vale, Fernando

Reed, Sawyer Patel, Jitesh



19

Reeves, Amy Hoossainy, Saudiqa

Repp, Heather Alizadeh, Diana

Russ, Veronica Harrell, Justin

Singleton, Bolynthia Mehta, Jyotir

Skinner, Callaway Reddy, Rani

Strain, John Fain, Guy

Taylor, Adaky Burton, Robert

Tingler, Questa Mitchell, Michele

Tioaquen, Cheryl Won, Johnny

Wan, Claire Platner, Robert

Watkins, Angela Williams, Shawn

White, William Garcia, Thomas

Wierichs, Laura Ogan, Kenneth

Williams, Allison Szabo, Stephen

Williams, Gregory Patel, Piyushkumar

Winter, Charles Hamilton, Julius

Yamamoto, Kristin Lawrence, William

Yardley, Sarah Lindsey, Steven

Zimmerman, Stephanie Homsombath, Bounthavy

Approve the following for licensure reinstatement with supervising physician:

McElroy, Martha Bennett, Ray

Approve the following Additional Duties Request:

Amanda Ashley, PA – Dr. Charles Leewood

Debridgements

Kevin Ballard, PA with – Dr. Glenn Kerwin

Paracentesis

Thoracentesis

PICC

Tunnelled PICC Line

Port Placement

Lumbar Puncture

Myelogram

Central Line Placement

Windy Bernard, PA with – Dr. Thomas Murphy

Tunneled PICC Line Placement

Image Guided Central Line Placement

Image Guided Port Placement

Image Guided Myelgram

Image Guided Lumbar Puncture

Image Guided PICC Line Placement



20

US Guided Thoracentesis

US Guided Paracentesis

Shea Box, PA with – Dr. Roger Williams

Central Line Placement

Tunneled PICC Line Placement

PICC Line Placement

Port Placement

Myelogram

Lumbar Puncture

Paracentesis

Thoracentesis

Dialysis Catheter Placement

Port Study

Erin Brandow, PA with – Dr. Michael J. Ray

Paracentesis

Thoracentesis

Lumbar Puncture

Myelogram

Tunneneled Vascular Lines (place/reveal)

Non-Tunneled Lines (place/remove)

Tanya Burnette, PA with - Dr. Marcus Brown

Stress Test Supervision (treadmill, treadmill nuclear, lexiscan nuclear, stren echo)

Matthew Cason, PA with – Dr. Darlene McNulty

Transcranial Magnetic StimulatioTreatments (determining motor thresholds, monitoring

patients during treatment, treatment planning)

Jessica Cobb, PA with – Dr. Jessica McCabe

Neuromodular Botox/Dysport

Dermal Filler

PRP Injections Including Hair Restoration

Laser Resurfacing

Jessica Cobb, PA with – Dr. Randal Rudderman

Neuromodular: Botox

Dermal Filler

Nancy Demester, PA with – Dr. Alan Zuckerman

Fluoroscopic Lumbar Puncture

Image Guided Peripheral PICC

Fluoroscopic Myelograms

Fluoroscopic GJ Catheter Exchanges

Image Guided Peritoneal Tunneled Catheter

https://www.gacsbme.org/gacsbme/download/attachments/264/AD+Burnette%2C+Tanya.pdf?version=1



21

US Thoracentesis

US Paracentesis

Image Guided Tunneled PICC

Image Guided Central Line

Image Guided Port Placement

Fluoroscopic GT Exchanges

Fluoroscopic JT Exchanges

Image Guided Vascath

Image Guided Permcath

Image Guided Pleural Tunneled Catheter

Fercilien James, PA with – Dr. David Sailors

Central Line Placement (Quinton, perm cath)

Stephen Lewis with – Dr. Michael Bosley

Port Insertion/Removal

Kierston Prasatik, PA with – Dr. Anterpreet Dua

Greater Trochanteric Bursa Injections

Eddie Simms, PA with – Dr. William Lee Ballard

VAS Catheter Placement/Insertion

Intra Aortic Ballon Pump Removal

Lauren Terrell, PA with – Dr. Israel Gaitan Rueda

Arterial Line

Central Venous Lines

Vas Cath

Elizabeth Thompson, PA with – Dr. Hugh F. Smisson, III

Surgical Site Marking

Lumbar Puncture

PA

Elizabeth Thompson, PA with – Dr. Hugh F. Smisson, III

Required 5 additional lumbar puncture procedures to fulfill the requirement of 10 procedures for

additional duties request.

Approve for Reinstatement pending additional information

Martha McElroy, PA with Ray Bennett, MD

Other Business:

1. Franklin, Michael: Add/Change application

2. Tabled for additional information

3. JD: Interview

4. MS: Interview



22

COSMETIC LASER COMMITTEE

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

unanimously.

The Board took the following actions.

Approved the following for Assistant Laser Practitioner –

Jessica Barra

Brianna Campbell

LaTrecia Chambry

Irana Couto

Stephanie Dills

Derrick Easom

Jennifer Girau

Tarsha Griffith

Courtney Jones

Melissa Latimer

Julie Lundeen

Tanya Padron

Manuela Pirvu

Valarie Smith

Christian Taylor

Mabel Cecilia Terrell

Chelsea Thaw

Approved the following for a reissue of Assistant Laser Practitioner –

Naureen Ali

Elisabeth Fishburne

Beverly Francis

Approved the following for Senior Laser Practitioner –

Brittany Haynes

Katherine Siedor

Approved the following for a reissue of Senior Laser Practitioner –

Katrina McClimans

Approved the following for reissue of Assistant Laser Practitioner with terms and conditions:

K. A.

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

the report by unanimous vote.



23


Incomplete:

Chin, Tiffany

Howard, Melvin

Blasingame, Derrick- Form B, CEU’s

Boyd, Jason- DUI Statement, Form B

Butler, Latoya- Form B, Verifiable document, NPDB

Nghiem, Jasmine- Form B, Resume, CEU’s

McDougal, Tammy- Form A, Form F, CEU’s

Prosise, Kaylyn- Illinois Verification

Rinville, Ernst- Form B

Rodriquez, Anna NBRC, Form B

Samuel, Jamycia- Resume

Scales, Roslenn- Formf, Form B

Tejeda, Brittany- Ca Verification, Form B

Milord, Marlise- Form A

Pagsisihan, Francisco- Resume

The Following applications were approved for licensure:

Armstrong, Aleya

Barnes, Melisha

Bascho-George, Zinahedia

Besse, Edward

Carter, Alexia

Connell, Spencer

Conner, Rylie

Daniels, Madison

Fabin, Melinda

Debel, Mahlet

Lucas, Brianne

Houston, Sydney

Jenkins, Jacquelyn

Lisa, Earl

McCloud, Tracy

Pace, Shinice

Reid, Victoria Teal, Holly

Rodriguez, Rachel White, Haley Williams, Anthony



24

Pending additional information Moreira, David

Cassity, Susan

Nazworth, Aimee

Rumachik, Danielle

Ricks, Keyanda

Reynolds, Shawna

Pineau, Andrea

Edison, Carmita

Miller, Jeffery

ACUPUNCTURIST COMMITTEE

Mr. Law presented the Acupuncturist Committee report to the Board as a motion. The Board

accepted the report by unanimous vote.


Accepted the following Quarterly Report:

Tram-Huong Gebreyesus

Approved the following application for Limited Licensure:

Alpha Bond – Ms. Cho recused

Approved the following applications for Reinstatement of Licensure:

Maria Delangre

S.A. – with conditions

Approved the following applications for Initial Licensure:

Robinson Gaviria

Danielle Pechac – Ms. Cho recused

Viviana Viera

Q-Baek Whang

Granted the following requests for acupuncture privileges to be added to Physician Licensure:

Margaret Boltja, MD

Arasi Thangavelu, MD

Other Business:

Accepted the list of limited licensees and supervisors as information.

Accepted the resignation of Li Jiang from the Advisory Committee.

Invited H.W. for a phone interview at the August meeting for the open seat on the Advisory Committee.



25

ORTHOTIST & PROSTHETIST COMMITTEE

Dr. Harbin presented the Orthotist & Prosthetist Committee report as a motion. The Board

accepted the report by unanimous vote.


Approved the following applications for licensure:

Kaitlin Cash Upgrade from Orthotist to Dual O&P

Gerald Counihan Upgrade from Prosthetist to Dual O&P

Elizabeth Kelly McMurray Orthotist

WELLNESS COMMITTEE

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

unanimous:

The Board took the following actions.

PHP report – Paul Earley, M.D. and Robin McGown

MH - Terminate criminal and probation with Cosmetology Board before license will be considered.

DB - Refer to GAPHP.

LL – Refer to GA PHP

PS – Invite for an interview.

BK – Invite for an interview.

INVESTIGATIVE INTERVIEW REPORT Dr. Harbin, presented the Investigative Interview report as a motion, and was seconded by Mr. Fowler.

The Board accepted the report by unanimous vote. The Board took the following actions.

20181594 OMPE 20182138 Close

20190078 Peer 20190493 LOC

20190693 Close

INVESTIGATIVE COMMITTEE The Investigative Committee report was presented as a motion by Mr. Fowler, and was seconded by Dr.

Harbin. The Board accepted the report by unanimous vote. The Board took the following actions.

Close:

20162379 20171732 20180066 20180076 20180463 20180506

20180558 20180582 20180586 20180630 20180639 20180824

20181361 20181531 20181577 20181824 20182084 20182128

20182222 20190104 20190165 20190171 20190310 20190537

20190543 20190585 20190776 20191581 20191625 20191654

20191718 20191721 20191748 20191826 20191837 20191838



26

20191966 20191973 20191977 20191995 20192040 20192045

20192136 20192140 20192174 20192188 20192211 20192214

20192237 20192246 20192256 20192285 20192292 20192298

20192305 20192306 20192307 20192315 20192317 20192318

20192319 20192323 20192326 20192329 20192339 20192357

20192373 20192375 20192401 20192423 20192444 20192449

20192462 20192510 20192515 20192532

Close with Letter of Concern:

20171292 20182105 20182107 20190212 20190780 20191673

20191686 20191687 20191689 20191954 20191960 20191976

20192048 20192049 20192058 20192093 20192122 20192128

20192173 20192261 20192311 20192338 20192347 20192372

20192424 20192457 20195252

Invite for Investigative Interview:

20190285 20190681 20191946 20192132 20192133 20192241

20192333 20192414 20192467

Further Investigation:

20190455 20190557 20190667 20190850 20190917 20192081

20192369 20192404 20192412 20190680

Table

20190686 20191630 20191830 20191831

Mirror Action from Other State

NONE

Attorney General’s Office

20191715

Peer Review

20170633 20172146 20172148 20172174 20191974 20192042

INITIAL COMPLAINT EVALUATIONS The Board approved the following recommendations.

20192343 20192346 20192501 20192504 20192518 20192533

20192536 20192549 20192569 20192570 20192573 20192576

20192577 20192579 20192580 20192581 20152583 20192584

20192585 20192595 20192601 20192606 20192607 20192608

RECUSALS Dalton 20192081 20192214 20192580

Norman 20192174



27

Reisman 20192375 20182138

Simmons 20191689

There being no further business, motion Dr. Harbin, seconded Mr. Fowler and motion carried to

adjourn the meeting at 3:38 p.m.

__________________________________ _____________________________________

Gretchen Collins, MD LaSharn Hughes, MBA

Chairperson Executive Director

georgia composite medical board minutes of the july 11

Documents