susan rogers, esq. mary fallin - oklahoma 2017 agenda & appendix.pdfsusan rogers, esq. executive...
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Susan Rogers, Esq.Executive Director
Board ofDentistry
Dr, James A. SparksOklahoma City,
OklahomaPresident
Dr. Michael HowlTulscI, Oklahomalst Vice President
Dr. Jeff LundclyNewcastle, Oklahoma
2nd Vice- President
Dr. Jim GorePryor, Oklahoma
Secretary/Treasurer
Angela Cralg' RDHEdmond, Oklahoma
Chief Phil Gotten
(Retired)Norman, Oklahoma
Loretta Roberts, Esq.Broken Arrow,
Oklahoma
Dr, Lisa NowlinElk clay, Oklahoma
Dr. Curtis BowmanEnid, Oklahclma
Dr. Audrey CrawfordGrove, OklahomcI
Dr. Joseph DarrowOKC, Oklahoma
Stephen McCaleb, Esq.
Judicial Counsel
OKLAHOMA STATE BOARD OF DENTISTRY2920 N. Lincoln Blvd., Suite B
Oklahoma City, Oklahoma 73105Phone 405/522-4844 Fax 405/522-4614
Mary FallinGovernor
AGENDARegular Board Meeting
January 20, 2017 at 9:00 a.m.2920 N. Lincoln Blvd., Board RoomOklahoma City, Oklahoma 73105
I. Meeting called to Order
2. Approval ofminutes from November 4, 2016 regular Board Meeting.
3. Executive Director's Reporta. Govemors Licensing Taskforceb. Reports and Budgetc. Upcoming Legislative Session
d. FDA drug safety notice - anesthesiae. Representatives from Associations
4. President's Reporta. WREB Report
5. Presentation by Ms. Kimber Cobb, RDH, from CRDTS and possible executive session for
proprietary testing information. Possible Executive Session pursuant to 25 O.S.? 307(B)(7) Discussion ofProprietary Confldential Testing Info-ation , Design and GradingMethods ofthe CRDTS exam. Testing materials are deemed not open records pursuant toTitle 51 O.S. §24A.5 (1)(e).
6. Discussion and Possible Action Regarding Dental Hygiene application from Tamara Gall,RDH (formerly Tamara Haluzak, RDH). (Item tabled from last meeting).
7. Assistant Dean, Paul Mullassaril, D.D.S. - Presentation regarding OU dental school.
8. Discussion and Possible Action regarding agreed order for Dr. Leisha Everett, DDS.possible Executive Session as authorized by 25 O.S. i307(B)(8) regarding the abovematter in order to engage in deliberations or rendering a final or intermediate decision inan individual proceeding pursuant to Article II ofthe Administrative Procedures Act.
(Continued from November 201 6 Meeting)
Board ofDentistry
Dr. James A. SparksOklahoma City,
OklahomaPresident
Dr. Ivlichael HowlTulsa, Oklahomcllit Vice President
Dr. Jeff LundayNowcastle, Oklahoma
2nd Vice- President
Dr. Jim GorePryor, Oklahoma
Secretary/Treasurer
Angola Craig, RDHEdmond, Oklahoma
ChiofPhil Cotton
(Retired)Norman' Oklahoma
Loretta Roberts, Esq.Braken Arrow,
Oklahoma
Dr. Lisa NowlinElk City' Oklahoma
Dr. Curtis BowmanEnid, Oklahoma
Dr. Audrey CrawfordGrove, Oklahoma
Dr. Joseph DarrowOKC, Oklahoma
Stephen McCaleb, Esq.
Judicial Counsel
9. Discussion and Possible Action Regarding Dentists/Dental Hygienists not in
compliance with CE Requirement. Possible Executive Session as authorized by 25 O.S.
§307(B)(8) regarding the above matter in order to engage in deliberations or rendering afinal or intermediate decision in an individual proceeding pursuant to Article II ofthe
Administrative Procedures Act.
lO. Discussion and Possible Action Regarding the Applications for Dental Licenses and
Dental Specialty licenses by Exam and by Credentials in Appendix "A" pending passage ofthe
jurisprudence exam or other items as listed.
I I. Discussion and Possible Action Regarding the Applications for Hygiene Licenses by
Exam amd by Credentials in Appendix 6A" pending passage of the Jurisprudence exam or
other items as listed.
l2. Discussion and Possible Action on Reinstatement Applications received by Dentists
and Dental Hygienists that were officially cancelled for non-payment by the Board as listedin Appendix "A."
l3. Discussion and Possible Action on Reinstatement Requests received by Dental
Assistants that were offlcially cancelled for non.payment by the Board as listed in
Appendix cA."
l4. Discussion and Possible Action Regarding Dental Assistants with Criminal History as
listed in Appendix I.A."
15. Discussion and Possible Action on Requests to Not Renew Applications submitted as
listed in Appendix i.A."
l6. Discussion and Possible Action Regarding Retirement Requests as listed in Appendixc¬A:`
I 7. Discussion and Possible Action regarding Notices of Deceased Dentists/Dental
Hygienists as listed in Appendix cA."
l8. New Business
l9. Adjoumment
DENTISTS BY EXAM- AGENDA ITEM # 10Jayanth Christian DDS 6908 Univ of Colorado 2016 *Pending Jurisprudence Exam
Long Nguyen DDS 6905 Creighton Univ 2013 *Pending JurisI)rudenee Exam
Layla Lohmann DDS 6904 OU20ll *Pending Jurisprudence ELarn
SPECIALTY BY EXAM- AGENDA ITEM # 10
Gabriel Luttrell DDS216Orthodontics
Jacksonville Univ 2016 *Issued General License #6623 6/20/I 4
Armando Retana DDS195Orthodontics
Univ ofFlorida 2016 *lssued General License #6896 on 1 I/9/l6
Michael Henneberry DDS215Orthodonitcs
OU 2016 *lssued General License #6590 on 5/29/14
Jeremy Dewbre DDS214Orthodontics
OU2016 *1ssued General License #6640 on 8/22/ 1 4
Courtney Caplin DMDl94
Univ ofFlorida 2015
*Pending Jurisprudence Exarn & Approval
Oral Surgery ofGeneral License
DENTISTS BY CREDENTIALS- AGENDA ITEM # 11Courtney Caplin DMD 6902 Univ ofFIorida 2009 *Pending Jurisprudence Exam
Gary Courtney DDS 6907 UMKC 1996 *Pending Jurisprudence Exam
Karlene Guasteferro DDS 6906 Ohio State Univ l986 *Pending Jurisprudence Ecam
Peter Kim DMD 6903 Univ of Pennsylvania 2010 *Pending JurisI)ruderlCe Exam
I)ENTAL HYGIENISTS BY EXAM- AGENDA ITEM # 12Miwa lmamura RDH 4024 Shoreline Comm. 2016 *Pending Jurisprudence Exam
Emily Hally RDH 4025 Utah College 2016 *Pending Jurisprudenco Exam
Leah Rutledge RDH 4027 Sam Joaquin Valley 200l *Pending Jurispradence Exam
Jessica Flake RDH 4028 Utah College 20l I *Pending Jurisl)rudence E)cam
DENTAL HYGIENISTS BY CREDENTIALS- AGENDA ITEM # ll
Tamara Gall RDH 4016 North Dakota College l990
*Tabledfrom November 20 I 6 Meetingpendinginveestigalion
Ash]ey Carlisle RDH 4026 Univof|N2013 *Pending Jurisprudence E)cam
Melinda Metzger RDH 4029 NE TX Comm. 2010 *Pending Jurispradence Exam
DENTISTSmENTAL HYGIENISTS- REINSTATEMENT REQUESTS - AGENDA ITEM# 12Judith Butler RDH 1186 Expiration: l2/3 I/2014 *All Dental Hygienists requestingreinslalerrlentareCECc)mplianlandhavepaidtherequiredbackfeestobeplclcedontheagenda.
Sarah Umstead RDH 3853 Expiration: l2/3l/l5
Darci Clayton RDH 3652 Expiration: l2/31/13
Debra Madison RDH l423 Expiration: 12/31/13
DENTAL ASSISTANTS REQUESTING REINSTATEMENT OF PERMIT - AGENDA ITEM# 13Name Permit # Expiration Date
Viviana Solis 4319 l2/3 I/2013
Sadie Allen 038 l2/31/2013
Holly Wilson 493l l2/3 I/20]3
Sarah Cheny 3255 12/3 I/2013
Dana Kirkbride 3690 12/3 1/2013
Jessica Whorton 2914 12/3 1/2013
Essence Henley 4206 12/3 I/2013
Misty Soltero 5328 l2/3 I/2014
Ashley Teal 2;J2:2. l2/3 I/2014
Megan Nieman 6023 12/3 1/2014
Amdrea Self 2466 12/3 I/2014
Van Hoang 4482 l2/3 I/2014
Dana Blazer-Wortham 448l 12/3 I/2014
Caleb Smith 5755 12/3 I/2014
Julie Taylor 3977 l2/3 I/2014
Christy Wilder 3935 12/3 1/201 5
Kimberlee Ator 5513 l2/3 I/2015
DENTAL ASSISTANTS REQUESTING REINSTATEMENT OF PERMIT- corer'd- J4GErvD4 JrEjW# r3Name Permit # Expiration Date
Madisen James 6378 l2/3l/2015
Merri Underwood 3902 l2/3 1/2015
Jamie Pacheco 2394 l2/31/2015
Glenda Fierro 459l 12/3 I/2015
Michelle Gorman 4912 12/3 1/2015
Kimberly Sylvester 1688 l2/3 1/2015
Amy Martin 6079 l2/31/2015
Brittany Sorrels 5184 12/3 1/2015
Becki Self 2467 12/3 1/2015
Melissa Keener 4936 12/3 I/2015
Keri Wilson 5032 12/3 I/2015
Denise Stone 37S7 l2/3 1/2015
Matecha Richardson 4786 l2/3 I/2015
Duyen Nguyen 5044 l2/3 1/2015
Jamie Stovall 6663 l2/3 I/2015
Kinsey Evans S736 12/3 I/2015
Raquel Monje 5868 12/3 1/2015
Lydia McDonald 4696 l2/31/2015
DENTAL ASSISTANTS WITH CRIMINAL HISTORY - AGENDA ITEM # 14
\Vhlinev hlaxev. DA\
February 20 I 6, Plttsburg CountyDill (!iSCI(ISe ()n
Child Neglect, Felonyrencwul (Ll}PIic(llil)I1
2 Counts-
Deferred until February 202 1
DENTAL ASSISTANTS WITH CRIMINAL HISTORY- cont`d - AGEr\H)A ITEM # 14
Nancy Lvsing,er. DA
Dill |liscll)se (m
Ianuary 9, 20;6;ITulsa County ",,;,/mi:;,V,;,/")
*Reduced to Reckless Driving' Guilty Flea
January 3 I, 2016, Tulsa County
DUI*Deferred sentence until 9/7/I 8
04/I 3/2007, McClain CountyForgery} 2nd Degree
Possession of False State LicenseUnlawful Possession of Controlled Dangerous Substance
*Deferred until March 201 3
I)ill NOT (liscIIISe,
lIIl (Ir)I)liCllli(I"
May 201 I, Oklahoma County
Domestic Abuse in the Presence ofa Minor Child*No information on disposition and did not address it in her statement submitted.
February 20 I 5, Oklahoma CountyBurglary, 2nd Degree
*Advises charge was dismissed and have no informatiom to show otherwise
Di(I lliscl()se, ()I|
llpplic(Iti()rl
December 20 I 5, Pittsburgh CountyUnlawful Possession of CDS without a Prescription - Felony
*Dismissed without costs
Possession of a Controlled Substance- Marijuana - Misdemeanor*Deferred sentence until May 27, 2020
Ariah Collins. DA
Luis Zammaron. DA
June 2002, Oklahoma CountyActual Physical Control
*Deferred but then violated and accelerated June 2005
June 2002, Oklahoma CountyPossession of CDS- Marijuana
*Deferred but then violated and accelerated June 2005
January 20 I 4, Oklahoma CountyChild Abuse- Felony
*15 Year Suspended Sentence until 2029
Di(I ntlrli(lily
tlisclose onIll)plication
DENTAL ASSISTANTS WITH CRIMINAL HISTORY- cont'd - AGENDA ITEM # |4
Nicole GreQrOrv. DA
I)iscI()seri ()I1September 20 I 6, Tulsa County /mn//i.////.///? ^J//.I.////(,//
Larceny From a House/Building- Felony //I,,, ,,// c./,,lr£,i,,I. WL,rL,*DefelTed until August 20 I 8 "wh.,),m1,,/. "
Unauthorized Use of a Credit/Debit Card*DefeITed until August 20] 8
Unauthorized Use of a Credit/Debit Card*Dismissed
Knowingly Receiving/Concealing Stolen Property*Dismissed
February 2016, Grady County
Possession ofCDS- Meth - Felony (2013)*Deferred until February 2025
I)II) |lisclose I)I1
llpl,licaii()n
Robert Jacke, DA
Domestic Assault and Battery by Strangulation - Felony (20|3)*Deferred until February 2018
Possession of CDS - Felony (2014)*Deferred until Feburary 2025
Possession of Paraphernalia (2014)*Deferred until February 201 8
Possession of CDS- Meth - Felony (2015)*Deferred until February 2025
REQUEST TO NOT RENEW- DENTISTSmENTAL HYGIENISTSmENTAL ASSISTANTS - AGENDA ITEM # 15
Name TypeLicense/Permit#
Issue Date City, State
Thanhvan Tram DDS 6012 6/9/2008 Cedar Park, TX
Dylan Patrick DDS t)JJJ 6/30/20 I 5 Richardson, TX
Travis Boyer DMD 6574 4/25/201 4 Pueblo West, CO
Keusung Yun DDS 6133 6/24/2009 Centreville, VA
William Poller DDS 6813 5/20/20 I 6 Fayetteville, AR
Stephen Clark DDS 4]00 6/8/ I 980 Norman, OK
Melissa Talbott DDS 6372 4/27/20 1 2 Colorado Springs, CO
Mark Nadler DMD 4444 2/l2/l983 Sam Ramon, CA
David Weiner DDS525044-Periodontics 08/l9/l995Ol/14/2000
OKC, OK
Daniel Spears DMD 6170 4/23/20 I 0 Columbia, SC
Stephen Knox DDS 6108 6/I 2/2009 Castle Rock, CO
Michael Nadauld DMD 6744 7 1212:0\5 Sandy, UT
David Maki DDS 5912 8/2/2006 St. Paul, MN
Brandt Howard DDS bJ '_\7 6/30/20 I 5 Overland Park, KS
Shelby Olson DDS 6804 5/20/20 I 6 Columbus, OH
Anastasia Theodorou DMD 6668 9/3/20 I 5 Rocky River, OH
Edward Christensen DDS 5890 2/2612!NfJ6 Mesa, AZ
Harneet Kaur DDS c`JC\\\ 8/l4/20]5 Fresno, CA
Seth Brooks DDS 658l 5/29/20 1 4 Knoxville, TN
Vikrum Nanda DMD6n 6;2.207-OIlhodontics l2/3l/1512/31/15
Oxnard, CA
Patricia McClory DMD674299-Pedodontics l2/31/l5l2/3l/15
Oxnard, CA
David Chun DDS 6553 I I/8/2013 Saipan, MP
Tons Shin DDS 6553 1 I/8/20]3 Phoenix, AZ
Vishal Panchmatia DMD 2/16/l918 6/20/20 I 4 Brooklyn, NY
Amanda Johnson RDH 3315 5/5/20l I C'asper. WY
Cierra Kuster RDH 3835 5/18/2015 Severance, CO
Tracy Brown RDH 3175 7 19 12fJfyf) Maryland Heights, MO
Paula Jomes RDH 669 6/Sl\9J7 Edmond, OK
Cheryl Cobb RDH 1894 lO/27/l995 Bethany, OK
Anne Babkiewicz RDH 3704 4/25/201 4 Corpus Christi, TX
Mary Cortez RDH 3098 4/2 I/2009 Katy, TX
Victoria Rupp DA 4894 N/A Gushing, OK
Gayla Grim DA 603 N/A Edmond, OK
Tammy Petty DA 6517 NI A. Chelsea, OK
Lacey Seward DA 2473 N/A Vero Beach, FL
Gerri Crenshaw DA 6449 NIA Sumter, SC
Sarah Paxton DA 7310 N/A Lookeba, OK
Leona Ford DA 3943 N/A Claremore, OK
An"\ Anc\l.eevz\ DA 7258 N/A Tulsa, OK
Mary Wil]iams DA 2:J36 N/AL OKC, OK
Krista Gesche DA lOl9 NIA Papillion, NE
Sheny Blankenship DA 230 NIA Shawnee, OK
Marie Lebron DA l602 N/A Lawton, OK
Ashley Chapman DA 6145 N/A Elgin, OK
Jennifer White DA 2949 NIA Collinsville, OK
Meagan Bums DA 7174 N/A McAlester, OK
RETIREMENT REQUESTS- DENTISTS/DENTAL HYGIENISTS - AGENDA ITEM # l6NAME TYPE LICENSE # LICENSE ISSUE DATE CITY, STATE
Larry Coggins DDS 3768 5/13/l976 OKC, OK
Richard Lc)ochtan DDS 3989 213l|9J9 Pickerington, OH
Lee Centracco DDS 3716 6/8l l97 5 Houston, TX
Charles Mclnnis DDS 3598 6/16/l973 Sapulpa, OK
Elbert Franklin DDS 4024 6/l9/l979 Sulphur, OK
Robert Oliver II DDS 3406 6/lO/1970 Tulsa, OK
Floyd Skarky DDS 3334 6/I I/l969 OKC, OK
Claud McKee DDS 3595 6/l6/l973 Tulsa, OK
Nanci Moll RDH 926 6/7/l98l Edmond, OK
Charlyn Hills RDH 979 I/9/l982 Broken Arrow, OK
Beverly Enderby RDH 1264 6/I 5/1985 Marietta, OK
Cynthia Henry RDH 617 5/l3/l976 Tulsa, OK
Gwen Reams RDH 764 6lSl\978 Tulsa, OK
NOTICE OF DECEASED DENTISTSmENTAL HYGIENISTS - AGENDA ITEM # 17NAME TYPE LICENSE # DATE OF DEATH CITY, STATE
J. Mark Felton DDS402lI01-Orthodontics
November 2016 OKC, OK
Kenneth Parks DDS 263S December 2016 Tulsa, OK
Diane Holsten RDH 1354 January 2017 Tulsa, OK
Timothy Moore DDS398l(Retired2014)
January 2017 Tulsa, OK