georgia composite medical board minutes of the december 3

Georgia Composite Medical Board

Minutes of the December 3, 2020 Meeting

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The Georgia Composite Medical Board (GCMB) held its regular meeting on December 3, 2020

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

Board members on the call:

John S. Antalis, MD

William Bostock, DO

Gretchen Collins, MD

Debi Dalton, MD

E. Dan DeLoach, MD

Charmaine Faucher, PA (ex-officio)

Judy Gardner, FASHP, Consumer Member

Alexander Gross, MD

Shawn Hanley, Consumer Member

Thomas Harbin, MD, Vice Chair

J. Jeffery Marshall, MD

Matthew Norman, MD

Andrew Reisman, MD

David Retterbush, MD

Barby Simmons, DO, Chair

Richard Weil, MD

Management and legal staff present:

LaSharn Hughes, MBA, Executive Director

Phyllis White, Executive Assistant

Jonathan McGehee, Director of

Investigations Latisha Bias, Enforcement

Supervisor

Legal staff on the call:

Max Changus, JD, Assistant Attorney General

CALL TO ORDER

Dr. Simmons called the meeting of the Georgia Composite Medical Board to order at 7:35 a.m.

AGENDA

Dr. Harbin submitted a motion, seconded by Dr. Marshall to approve the agenda of the December 3,

2020 meeting. The motion carried unanimously.

MINUTES

Dr. Retterbush made a motion to approve the minutes of the November 5, 2020 meeting. Dr. Gross

seconded the motion and it carried unanimously.

SWEARING IN

The Board conducted the swearing in of Judy Gardner, Consumer Member, and welcomed her to the

Board.

CHAIR’S REPORT

Dr. Simmons made the following report.

Dr. Simmons thanked the Board staff for all of their hard work and requested feedback from the Board

members regarding the audit.

EXECUTIVE DIRECTOR’S REPORT

LaSharn Hughes, Executive Director presented the following information:



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Provided an update on the staff, there are two positions posted for applications specialist to replace staff

that resigned due to child care issues with the pandemic.

Reminded the Board of the date for the January meeting, which will be virtual.

Reviewed the FSMB Member Survey of interesting topics the Board is interested in.

Ms. Hughes presented the response to the Performance Audit for the Board to review. Dr. Simmons,

Chair, noted that the Board will review and make improvements from the recommendations from the

Audit.

RULES REPORT

Rules for review

Motion Dr. Retterbush, seconded Dr. Norman and motion carried to post the following Rule for

comment:

Rule 360-3-.02(12) “Unprofessional Conduct Defined.”

Motion Dr. Norman, seconded Dr. Deloach and motion carried to send the following Rules to the Office

of the Attorney General:

Rule 360-3-.05 “Renewal Applications”

Rule 360-32-.01 “Definitions”

Rule 360-32-.02 “Requirements for Nurse Protocol Agreements Pursuant to Code Section 43-34-

25.”

The Rules Committee will look at Definition Guidelines for APRN’s and discuss the need for specific

protocols.

CLOSED SESSION

Dr. DeLoach motioned seconded by Dr. Dalton to go into closed session to discuss applications,

investigations and disciplinary matters. The motion carried unanimously.

OPEN SESSION

Dr. Simmons declared open session.

PRESENTATION TO THE BOARD

Keisha Callins, MD, from MAG gave a presentation to the Board on Physician Resiliency. The Board asked

questions and thanked Dr. Callins for her informative presentation.

PRESENTATION TO THE BOARD

Travis P. Lindley, Georgia Psychiatric Physicians Association, Erin Philp and Tim Clement, American Psychiatric Association gave a presentation to the Board on Covid19: Telepsychiatry Model Legislation.



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The Board asked questions and thanked them for an informative presentation.

ATTORNEY GENERAL (AG)

Max Changus, Assistant Attorney General presented the AG Status Report. Dr. DeLoach submitted a

motion, seconded by Dr. Marshall and motion carried to accept the report as information and approved

the following Board Orders:

1. Still, Odell—Public Consent Order

2. Petrovich, Linda—Public Consent Order

PHYSICIAN LICENSURE COMMITTEE

Dr. Retterbush presented the Licensure Committee Report:

The Board took the following actions:

Rule Waiver Petitions

Approved:

Sufi, Ajay 360-2-.02(6)

Schleich, Arno 360-2-.02(6)

Omer Ahmed, Aljaaly 360-2-.02

Mark Krakovitz Rule 360-2.01

Denied:

Lataban Lopez, Lidya 360-2-.01(1) Based on no ECFMG certification

Procedure Discussion

Forms/Verification Discussion,

MP –

LaSharn Hughes, Executive

Director

1. Signature over Reference Form envelope seal not

required.

2. Continue 2016 criteria for committee review of

malpractice cases:

a. If a provider has a malpractice case that is

less than 10 years with an award.

b. If a provider has 3 or more pending

malpractice cases.

c. If a provider has 3 or more malpractice

cases with an award regardless of age.

d. Do not refer a provider who had a

malpractice case during

internship/residency.

https://www.gacsbme.org/gacsbme/download/attachments/360/DOC_sufi+waiver.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/DOC+SCHLEICH.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/WAIVER+A+AHMED.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/Waiver+Mark++Krakovitz.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/lataban+waiver.pdf?version=1














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Compact requirements –

LaSharn Hughes, Executive

Director

Refer to AG questions related to Compact

requirements.

Applications Approved

Initial/Reinstatement

Barbara, Joaquin

Bucky, Louis

Carpenter, Marshall

Comey, Christopher

Daly, Rosemary

Duviver, Herbert

Ghanta, Guru

Horne,Robert

Levy, Michael

Meade. Paul

Patel, Bipinchandra

Ramas, Carla

Replogle, Corinne

Tran, Nha

Administrative License

Byrne, Thomas

Approve Pending Information

Erwin, William If cleared by GA PHP

Applications Not Approved

Interview

ES

MG

Clinical Skills, allow to withdraw, or deny

HC Based on no clinical practice since 2013

PR Adm License or Clinical Skills Examination, allow to

withdraw or deny b/o last clinical practice of medicine in

2016.

Deny

EL Based on actions in other states. (Dr Retterbush recused)

Table for additional information

OR

SS

ED

https://www.gacsbme.org/gacsbme/download/attachments/360/CR+B+JOAQUIN.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/CR+M+CARPENTER.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/CR+D+ROSEMARY+2.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/CR+H+DUVIVER+2.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/Ghanta%2C+Guru2.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/levy+app.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/meade+app.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/DOC_CRAMAS_REVMAT.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/DOC_CREPLOGLE_REVMAT.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/doc+ntran+rvw+mat.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/Erwin%2C+William.pdf?version=2













https://www.gacsbme.org/gacsbme/download/attachments/360/CR+T+BYRNE+ADMIN+3.pdf?version=1



https://www.gacsbme.org/gacsbme/download/attachments/360/DOC++RUBINTON+RVW+MAT_0001.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/DOC++SCHWARZ+1.pdf?version=1

























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Uphold Previous Decision

MC

HH

Accepted as Information Only

Al Haj Ali, Emad - Withdrawing Application

Applications Administratively Approved

PHYSICIAN NAME DEGREE

Akhtar, Mahfuza MD

Almasarweh, Saleem I MD

Anderson, Tarek MD

Anees, Farah MD

Anid, Youssef S MD

Aromin, Jourdan T MD

Aron, Talia M MD

Aspin, Mary MD

Aubin, Golnaz MD

Bailey, Joushua DO

Bajaj, Shalini MD

Barbara, Joaquin J MD

Behroozi, Saeid MD

Beveridge, Robert O MD

Bobb, Wendell T MD

Brass, Tara L MD

Brehm, Anthony MD

Byrne, Thomas G MD

Cantwell, William S MD

Capps, Richard H, Jr MD

Carle, David A MD

Carpenter, Marshall MD

Carvajal, Jonathan MD

Chater, Kamal MD

Chu, May-Lynn S DO

Coffee, Megan P MD

Cook, Matthew W MD

Corey, Shawn A MD

Cottrell, Bradford L MD

Cunningham, Lewis N DO

Daley-Placide, Racquel MD

Daly, Rosemary DO

Damski, Paul E MD

Danilkowicz, Richard MD

https://www.gacsbme.org/gacsbme/download/attachments/360/E+AL+HAJ+ALI+WITHDRAW+APP.pdf?version=1

https://www.gacsbme.org/gacsbme/download/attachments/360/Hercule%2C+Hantz+.pdf?version=1







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Daugherty, Lauren N MD

Dave, Ritu MD

Davies, Oluwaseun MD

Deliere, Samantha A MD

DePasquale, Anne S MD

Dogan, Ekrem MD

Donnellan, William B MD

Duvivier, Herbert MD

Elango, Vishalakchi MD

Elangwe, Patrick M MD

Etchells, Christopher W MD

Evans, Susan MD

Fareedi, Omar F DO

Fleck, Randolph P MD

Foster, Sarah J MD

Friedmann, Craig H MD

Frimpong, Thomas DO

Gaffney, Christopher E MD

Gallagher, Christopher M MD

Gamber, Mark A DO

Garrett, Susan T MD

Garvin, Sicily E MD

Geha, Mayya MD

Gertz, Henning E MD

Ghannam, Waseem MD

Ghanta, Guru MD

Gray, David MD

Gray, Walter J MD

Green, Michael B MD

Greene, Alice MD

Grewal, Jessie MD

Gupta, Anand K MD

Gupta, Shaminder M MD

Haden, Douglas W MD

Hahn, Mark DO

Hartley, Tucker D MD

Heberer, Meredith A MD

Helton-Skally, Kathy J MD

Hill, Katherine B MD

Hoang, Long N DO

Homeier, Diana C MD

Horne, Robert L MD

Howell, Tamieka M MD



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Iafolla, Ayne K MD

Ibrado, Ana Marie Ray R MD

Ingram, Maya F MD

Iqbal, Aamir MD

Jackson, Andrew B MD

Jain, Nikhil MD

Jani, Alap R MD

Jerez Bharwani, Catherine MD

Jerome, Mairin A MD

Joshi, Nirmal MD

Kanies, Teresa I MD

Karamchandani, Girish J DO

Kazmi, Murtaza M MD

Kim, Eugene T MD

Kim, Paul J MD

Kouloumberis, Pelagia E MD

Krishnamani, Keerthy MD

Lacy, Timothy L MD

Larios, Angelica M MD

Ledbetter, Dawn J MD

Legere, Henry, III MD

Levy, Michael MD

Majid, Hashir MD

Mandzuik, Michael J MD

Mangal, Vipul MD

Mangunta, Venkat R MD

Manny, Julia MD

Marion, Loretta M DO

Marlowe, Kimberly J MD

Mason, Jerimiah E MD

McGregor, Andrew C MD

McKee, Debra L DO

McMillan, Lyndsey A MD

Meade, Paul G MD

Meakin, Charles J MD

Mehta, Smita MD

Meltzer, Daniel L MD

Merchant, James T MD

Merchant, Naveed MD

Michael, David M MD

Mlynek, Karolina S MD

Mocnik, Jack J, Jr MD

Mohini, Shiv S MD



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Mohiuddin, Khaja K MD

Molloy, Danielle M MD

Moosavi, Harrison S MD

Mostafavi Naeini, Bardya MD

Mughal, Sanjay MD

Nally, Margaret MD

Nannapaneni, Srikant MD

Nguyen, Nixon DO

Nguyen-To, Nguyet A MD

Nordstrom, Carla R MD

Oakes, Michael F MD

Oliva, Elishia M MD

Oliver, Matthew MD

Omer Ahmed, Aljaaly MD

Ortega-Fonte, Kristine MD

Palacios Vazquez, Hugo MD

Palo, Jose E MD

Palwai, Aishwarya MD

Pando, Brian L MD

Pape, Gregory S MD

Patel, Bipinchandra MD

Patel, Depen J DO

Patel, Katan Y DO

Patel, Parth B MD

Peled, Ziv M MD

Pella, Pablo M MD

Perry-Fabrizio, Gerren S MD

Pineda, Natalia MD

Ponce, Brent A MD

Rai, Anupa MD

Raman, Dileep MD

Ramas, Carla V MD

Rana, Asim I MD

Rashad, Muhammad MD

Rashid, Omar M MD

Ravichandran, Pranavi MD

Reddy, Narra S MD

Reif, Michael S MD

Replogle, Corinne MD

Roberts, James MD

Roemer, Howard MD

Ronchi, Mark G DO

Roy, Aviral MD



9

Salah, Yusuf M MD

Saling, Lauren J MD

Sanders, Kimberly MD

Santosa, Katherine B MD

Schwanebeck, David J DO

Sheehan, Patrick J MD

Simpson, Venita M MD

Singh, Sunali P MD

Sivak, Joseph J MD

Smith, Bert J MD

SONIA, FNU MD

Srinivasamaharaj, Srividya MD

Steencken, Gregory S MD

Stroming, Scott L MD

Suarez, Carlos A MD

Sufi, Ajay S MD

Sutphen, Rebecca MD

Sweeten, Keri M MD

Tabi, Ayuk E MD

Taggart, Tracy A MD

Tatsas, Alon MD

Thompson, Matthew MD

Thorpe, Rachel MD

Tran, Nha P MD

Tuckman, Glenn MD

Vachharajani, Punit A MD

Velasquez, Nathalia MD

Versaggi, Salvatore L MD

Vora, Aadil H MD

Wade, Thomas M MD

Walker, Joshua A MD

Wallins, Joseph S MD

Williams, Jason P MD

Wisiorek, Michael F DO

Woodbury, David M MD

Woods, Glenn M MD

Yap, Vanessa MD

Yen, Sophia MD

Ziel, Gilbert E MD

Zuriarrain, Alexander MD



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NURSE PROTOCOL ADVISORY COMMITTEE

Dr. Gross presented the Nurse Protocol Report:


The Committee recommended the following:

1. Invite Camille Brockett-Walker to an interview for the Committee. In addition, reach out to the

Nursing Board, Georgia Nurses Association, etc. for application to interview for Psych or Acute

Care NP.

2. The Committee reviewed the rules and updated materials. Refer the rules to Rules Committee

and send new forms to the Nursing Board.

The following Form C’s were approved:

➢ Elango, Theresa

➢ McNear, Jennifer

➢ Petty, Allison

➢ Stonecypher, Christina

➢ Stroud, Melissa

➢ Thorne, Julia

➢ Triche, Shirley

➢ Tucker, Nancy

• There was noted to have investigation see about the physician clinic for Melissa Stroud. Her

liposculpture was not approved.

The Committee reviewed and approved the following protocols under the provision of O.C.C.A.

43-34-25.

APRN Delegating Physician

Balaban, Anna William Whaley, MD

Banach, Hannah Lina Harper, MD

Collins, Kenyatta Tse-hwa Yin, MD

Guerrero, William Daniel Wood, MD

Kennedy, Tarsha Joshua Myers, MD

Kenser, Martin Ashley Poullard, MD

Keys-Cleveland, Ivy Ateeqahmed Patel, MD

Lavin, Lindsey Immanuel Hsu, DO

Micourt, Darly Melissa Sanchez, MD

McCall, Hannah Lashunda Williams, MD

Richard-Reynolds, Karen Immanuel Hsu, DO

Rushing, Stephanie Ramin Sadeghi,DO

Phan, Lily Melvin Williams, MD

Thompson, Drew Ochuko Odjegba, MD

Thomas, Maritess Lashunda Williams, MD

Bonds, Kalisha Theodore Johnson II, MD



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Holland, Jennifer Sujatha Reddy, MD

White, Katherine Brandon Roberts, MD

Shoemaker, Savannah (resubmit) Christopher Parks, MD

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

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


Edouard, Raymond Regan Frake, MD

Tettey-Enyo, Phyllis Ranjana Bhargava, MD

Goodman, Susannah Benoy Varghese, MD

Jinright, Stephanie Ezad Ahmad, MD

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

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


Cahambing, Janice Sajad Zalzala, MD

Fur, Kara Ellis Mossaded, MD

Traverson, Maria Bradley Leshnover, MD

Pasko, Brittany Sasidhar Guthikonda

Payne, Melissa Carlos Buckhammer

Bell, Kimberly William Shivers Jr., MD

Horne, Tracey Theresa Courtney


Salimonu, Janet Steven Lee, MD

Standley, Yarvarious Henry Sakow, MD

Protocols Administratively Reviewed:

The following protocol agreements meet the provisions of OCGA 43-34-25:

APRN Last APRN First Middle Supervising Physician Name

Balaban Anna William Whaley

Banach Hannah Lina Harper

Blackstock Terrilyn Mridula Vinjamuri

Bostic Ashley Patricia Ayoung-Chee

Bowers Dale Roland Nash

Brown Takaya Kimberly Brown-Gullatt

Broxton Ivey Samuel Belknap

Buchanan-Cummings Thyra Stuart Pancer

Burgess Dellinia Arif Patni

Campbell Jr. Jimmy Brandon Dawson

Chitoh John Richard Chase



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Clanton Courtney Nakeisha Otto-Stewart

Clark Kathleen Jeffrey English

Collins Kenyatta Tse-hwa Yin

Cook Kristen Thomas Williamson

Cordle DeAnna Rita Khurana

Crabb Jolyn Shumet Lonsako

Daniel Maria Thomas Gore

Ernest Michelle Benjamin Watson

Fitzgerald Cynthia Andrew Horowitz

Fitzgerald Cynthia Michael Peacock

Ford Latasha Sarita Sharma

Fowler Beverly Richard Pearson Jr.

Freeman Martha Alfred Martin

Gallemore Tekeria Layth Saymeh

Garofano Philip Sanjeev Bhavnani

Goodson Jennifer Edan Shapiro

Green Natalie Alfred Martin

Henry Sherre Sanjeev Bhavnani

Hooks Precious Roland Nash

Keene Richard Rhonda Moorman

Kendrick Patricia Alfred Martin

Lee Seo Andrew Kirsch

Linticum Kimberly Michael Quinn

Littleton Morgan Chad Costley

Lutumba Judith Ibrahim Opaleye

Merck Linne Hicham Churbaji

Moore Nicole Alfred Martin

Noto Penny Julie Dahl-Smith

Ogwotu Ralph Theodore Morgan

Pass Sherry Crystal Bright

Peoples Sabrina Jordan Smith

Perdomo Kelly Roland Nash

Pinckney Brandi Richard Wright

Polk-Seldon Gabrielle Michelle Montalvo

Reid Shannon Afolabi Tiamiyu

Roberson Audrey Joel Isom

Safo Joy Sujatha Reddy

Sizemore Jennifer John Strunk

Statham Annie Ronald McLean

Sutton Autumn Anthony Carter

Taylor Erica Ranjan Avasthi



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Thompson Elizabeth Jon Risley

Torke Brittany Jacqueline Anglade

Travis Lucille Gloria Richards

Vermillion Iliana Jorge Rodgriguez

Waters Ansley Atul Khurana

Watson Stephen Pulinkumar Patel

Weldon Carey Billy Price

Williams Tina Jimson Smith

Wright Heather Alan Brown

Zeagler Melissa Bryson Greenwood

Any Old/New Business

Emory is looking to do certificate programs for psychiatric N.P. A suggestion was made that the Board

may want to do an insight on what classes would be needed.

PHYSICIAN ASSISTANT ADVISORY COMMITTEE

Dr. Antalis presented the Physician Assistant Committee report.


The Committee recommends approval for the following applications for initial licensure with a

supervising physician:

PA Supervising Physician

Candice Hite Srihari Makempati

Ivan Friant Brian Pisula

Jessica Pulliam Robert Park

Tiffany Searle Derek Culnan

Anna C. Moses Brian Zeh

Shannon Dieffenderfer Gary Berliner

Desiree Cleveland Angela Redding

Jessica Wood Edmond Ritter

The following applications were tabled for additional informaiton:


William Bible Jeffrey Visser

Ryan Bowman DeAnn Champion

Gary Peter D’Aluisio Jeffrey Visser

Hunter Lynn Charles M. Spivey



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The Committee recommended approval of the following applications for initial licensure without a

supervising physician:

PA

Cristina Baldassarri

Philip Franklin

Terica Burkins

Ediah Ochieng

Spenser Rice

Luke Mentzler

Igor Alvarez-Forte

Kevin Nguyen

Caroline Szyperski

Rachel Farmer

Joseph Alfera

Josh Harcey

Karla Rodriquez

Daniel Shiffman

Sanjuana Maria Rodriguez

Michael Johnson

Jessica Smith

Chelsea Tersavich

Jared Shipley

Justin Vinomon

Benny Wilkerson

Marissa Akin

Zack Haggains

Amanda Laufer

Diana Lee

Christina Naranjo

The following applications were tabled for additional information:

Gina Davis

Kevin Robertson

Jason A. Elliott

Jacqueline Evans

Kasey Keane

Mike Overgaard

Benny Wilkerson - Reinstatement

The following applicants are scheduled for the interview

GJ

AO



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Approved the following applications for reinstatement without a supervising physician:

PA

Saipriya Neti

Approved the following requests for additional duties:

Rachel Davis – Joe Clifton

Injection of Neuromodulators

Injection of Dermal Fillers

Damon Denzia – Robert Taarea

Chest Tube Insertion

Insertion of Arterial Lines

Insertion of Central Venous Lines

Damon Denzia – James Ryan Burke

Endoscopic Vessel Harvesting

Central Line Placement

Chest Tube Placement

Kristofer Foreman – Darren Naugles

Aesthetic Facial Injections (Boxtox & Fillers)

Michael S. Kelleher – Angelina Postoev

PDO Threads

Administration of Cosmetic Neuromodulator

Platelet Rich Plasma

Dermal Filler

Brandy Nichols Owens – David Bustos

Arterial Line placement

Intubation

Thoracentesis

Central Line Placement (for access; for dialysis)

Parenthesis

Heather Reger - Michael Quinn

Arterial Line placement

Central Venous Catheter Insertion

Emily Grayson – Jason R. Levy

Tunneled/Central Line Placements

Approved the following Add/Change applications:


Allen, Anthony Kuttappan, Allen

An, Ui Pencea, Viorica



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Ashmead, Samantha Reddy, Ram

Baron, Allyson Whyte, Kristy

Baron, Allyson Whyte, Kristy

Benson, Kyle Dukes, Richard

Bowers, Amanda Lagaly, William

Brand, Cynthia Barret, Justin

Brockett, Michael Hazzard, Matthew

Broderick, Jessica Nagel, Kerry

Brown, Jessica Vaughan, Audrea

Brown, Kirk Fashola, Yomi

Buteau, Joane Chivukula, Kaavya

Caputo. Nicholas Ahmad, Anbar

Cayetano, Heejin Lalitha, Bandi

Colson, Melissa Keeling, Wiliam

Cooke, Carla Edupuganti, Srilatha

D'Alessandro, Bethany Yager, Howard

Davis, Berrian Street, Thomas

Didier, David Rogers, Michael

Fouch, Scott Munger, Ian

Friend, Gary Joyner, Earl

Fritzsche, Allison Beringer, Donald

Fuller, Thomas Chapman, Douglas

Gandhi, Chhaya Mendoza, Michael

Glass, Kenneth Patel, Nimisha

Graham, Kelly Walpert, Kimberly

Gumucio, Leah Perry, Cary

Gusick, Reena Whyte, Kristy

Harris, Vabah Ellington, Thomas

Heimbecker, Molly Turner, Suzanne

Hendrix, Joseph Sheffield, Jeri

Hobby, Maci Alba Yunen, Rafacel

Howard, Shey Taarea, Roberto

Hudson, Kevin Henkel, Paul

Hulsey, Tatum Haddadm, subab

Jennings, Ronald Zaman, Saif

Jones, Alexa Ritu, Chandra

Kleiber, Samantha Grunch, Betsy

Kryak, Brandon Minter, Jon

Lafont, Derek Neal, Dianna

LePage, Lindsay Crain, Dominique

Lightfoot, Jenna Walvaven, Jamie



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Luttjohann, Jarrod Asrael, David

Manry, Jennifer McCabe, Jessica

Marzolf, Lauren Silva, Antonio

Massad, Georgiana Deavens, Todd

Mathis, Donna Whyte, Kristy

McGraw, Carmen Baliga, Bantwal

Mewman, Eric Culnan, Derek

Mitchell, Donna Vashi, Satyam

Moon, Crystal Carter, Clinton

Nalley, Dane Taylor, Byron

O'Connell, Matthew Daneshmand, Mani

Oduah, Adanma Nguyen, Jacqueline

Ojukwu, Magnus Perry-gilkes, Lisa

Olds, Nicole Hill, Lauren

Olds, Nicole Rubin, Tod

O'Meara, Kathryn Agarwal, Pooja

Overton, Kenan Patel, Nimisha

Pagadala, Rekha Olusegun, Salami

Parris, Stephanie Silvers, Michael

Patel, Nisha Hazzard, Matthew

Patel, Prital Theron, Thompson

Ramsey, Kristyn Koganti, Deepika

Reger, Heather Quinn, Michael

Russell, Christopher Haynes, Anita

Russell, Christopher Russell, Wendy

Ryba, Jordan Hayes-Boucher, Angela

Sanchez, Tonya Khan, Sofia

Sanders, Jennifer Ghiathi, Abdollatif

Sangster, Philip Cochran, Robert

Seda, Lina Hord, Kevin

Sims, Larry Ulrich, Lane

Smith, Jennifer Garcia, Thomas

Spencer, Jason Bray, David

Straus, Jessica Whyte, Kristy

Thomas, Alexa Hammel, Josh

Thomas, Larry Hammonds, Charles

Thornton, Jonathan Furie, Eric

Timms, Dixie Robinson, William

Tucker, Claire Davenport, Jeffrey

Union, Joseph Zelisko, John

Union, Joseph Weirong Ding



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Vargas, Nijja Lin, Danielle

West, Erica Cochran, Robert

White, Paul Sapp, John

Williams, Michelle Goza, Wendy

Worfel, Courtney Gordon, Eric

The following Additional Duties request were tabled for additional information:

Claudia Griffin – Alexandra Feliciano

Botulinum Toxin Injection – need procedure logs

Brandy Nichols Owens – David Bustos

Chest Tube Placement – need four additional procedures

Other Business:

James P. Lunsford, PA-C, CAA –thank him for his interest will keep him in mind for future openings.

CH, Questions regarding the requirement for shadowing. Must meet the terms and conditions of the

Consent Order and obtain an OMPE by approved evaluator.

Shadowing Hours

Bridget Alsup – completed

Tricia J. Storteboom – need 102 additional hours

AC-1 Forms Discussion – the staff is required to scan and post these to the website. It is a requirement

in the law. These forms require an original signature for the PA and the Delegating Physician and the

alternatives can be a stamp or electronic signature.

COSMETIC LASER ADVISORY COMMITTEE

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

unanimously.


Approved the following for Assistant Laser Practitioner –

Julie Brown

Sandrika Bryant

Katelyn Chafin

Nichole Cyrus

Tasha Graham

Anslee Jackson

Anna Jamison-Postell

Taloria Jones

Cala Kelly

Jenifer Kim

Tyra Mann



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Samiya Manning

Deborah Moore

Altra Morris

Molly Mudd

Heather Reiber

Andrea Robbins

Juanita Thompson

Sydney Tracy

Kiesha Turner

Stacey Wellington

Stefanie Williamson

Angelica Woods

Approved the following for a reissue of Assistant Laser Practitioner –

Ashley Mekrut

Approved the following for Senior Laser Practitioner –

Melissa Walker

Approved the following for Assistant Laser Practitioner with conditions –

M.C.

Tabled the following for Assistant Laser Practitioner –

C.R. – for additional information

RESPIRATORY CARE ADVISORY COMMITTEE

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

report by unanimous vote.


Correspondence

The Committee interviewed Sondrea Croswell, Nadya Khoja and Harold Oglesby for advisory board

member roles. The Committee will schedule additional interviews for next month before a final decision

is made.

Reinstatements:

Noles, Pamela

Danie’r, Kimberly

Brantley, Carla

Cicerone, Stephanie

Sinclair, Jessica

Busbee, Ivey

McClain, Jeanette- pending additional information

Huff, Angela pending additional information



20

Full Licensure:

Bin Daeg, Abdulaziz

Wallace, Rylea

Beard, Maresa

McBryar, Haleigh

Stevens, Jimmy

Lehmann, Jessica

DeZarn, Hannah

Coulter, Vanessa

Tesfa, Elsa

Pendergrass, Valarie- pending additional information

Collins, Kevin- pending additional information

Sherri, Rollins- pending additional information

Jackson, Denetra- pending additional information

Michels, Stephanie- pending additional information

Ibrahim, Diana- pending additional information

Lima Neto, Pedro- pending additional information

Temporary:

Neptune, Winscika

Brown, Shontoria

Albany State University:

Brown, Shambrea - pending additional information

Seay, Quin’Neisha- pending additional information

Williams, Kadesia- pending additional information

Tollefson, Amber- pending additional information

Miller, Sheniqua- pending additional information

Summerlin, Tabitha- pending additional information

Bonner, Alanesha- pending additional information

Cheek, Christy- pending additional information

Powell, Jason- pending additional information

Miley, Maria- pending additional information

Embry, Blake- pending additional information

Coastal Pines Technical College:

Hague, Hannah - pending additional information

Jackson, Fatisha - pending additional information

Taylor, McKayla - pending additional information

Anderson, KaDee - pending additional information

Sironen, Ashley- pending additional information

Colson, Alanna- pending additional information

Lim, John- pending additional information



21

Oconee Fall Line Technical College:

Brown, Natalie- pending additional information

Hooks, Carly- pending additional information

Tydings, Christi- pending additional information

Johnson, Patricia- pending additional information

Howard, Latressia- pending additional information

Norris, Jessica- pending additional information

Horne, Katelyn- pending additional information

Knight, Shelbie- pending additional information

Fluker, Raegan- pending additional information

Rainey, Alanea- pending additional information

Southern Crescent Technical College:

Chaperon, Ariel- pending additional information

Reese, Princetta- pending additional information

Brent, Alexis- pending additional information

Mitchell, Deanna- pending additional information

Morrison, Michelle- pending additional information

Baxter, Sarah- pending additional information

Harris, Brianna- pending additional information

McCard, January - pending additional information

Brown, La’Shandis- pending additional information

Dewberry, Keisha- pending additional information

Pierre-Louis, Arielle- pending additional information

Ammons, Nicole- pending additional information

Howard, Hannah- pending additional information

Stiles, Hailee- pending additional information

Robins, Taylor- pending additional information

Jackson, Tiarra- pending additional information

Owen, Christopher- pending additional information

Donnerson, Sasha- - pending additional information

Administrative Upgrades

Caroline Lawson

Landon Moody

Ke’Shawna Gallien

Lorna Lawrence-Mitchell

Natalie Hawkins

Michael Purvis

Brittany West

Onnie Moss

Angela Floyd

Tina Wells

Michael Thorne

Jacquelyn Sims

Sherice Vilsaint



22

Rebecca Brady

Julius Corker

ACUPUNCTURE ADVISORY COMMITTEE

Dr. Bostock, presented the Acupuncture Committee report as a motion and it carried unanimously.


Accepted the quarterly report and approved the upgrade to full licensure for the following:

Yiqiang Zhou

Approved the following for reinstatement of licensure with conditions:

S.Z.

Other Business:

The Committee accepted as information the list of limited licensees and supervisors.

PAIN MANAGEMENT COMMITTEE

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

report by unanimous vote.


1. Correspondence

• The Committee approved the request from Marcellis Mathews at Elite Neurology Group &

Personal Injury regarding the legality of a doctor to E-Prescribe via Zoom while NP physically

sees the patient.

Approved the following for pain clinic licensure:

Application # Pain Clinic Name

F554046 United Spine and Ortho, LLC-Atlanta

F554303

Southern Pain and Spine- Gainesville

Lic # 459

Pain Care, LLC- McDonough

Change of Ownership

Lic # 313

Pain Care, LLC- Griffin

Change of Ownership

Lic # 435

Pain Care, LLC- Johns Creek

Change of Ownership

Lic# 311

Pain Care, LLC- Newnan

Change of Ownership

Lic # 312

Pain Care, LLC- Stockbridge

Change of Ownership



23

Lic # 470

Pain Care, LLC- Fayetteville

Change of Ownership

Approved the following applications that were administratively approved.

License # Pain Clinic Name

478 Axis Pain Center

Delete APRN, Stephanie Burris

224 Harbin Clinic, LLC

ADD Practicing Physician, Lucie Mitchell, DO

ORTHOTIST & PROSTHETIST ADVISORY COMMITTEE


Approved the following application for licensure:

Devin Howard – Upgrade to Dual O&P

Other Business:

Application Form B (Reference Form) instructions to be changed to read – Custom shoes, foot

orthotics, and/or knee braces are not accepted.

Board staff to inform D.S. that BOC certification is not accepted for Georgia licensure. He must

be certified through ABC.

GENETIC COUNSELORS ADVISORY COMMITTEE

Dr. Deloach presented the Genetic Counselors Advisory Committee report.


Applications Approved

Emily Becraft

Samantha Culver

Ashley Daley – pending additional information

Jullianne Diaz

Katelyn Kobara

Danielle Lemke

Sarah Mantia

Lindsey McNeely

Jessica Mercieca

Kyla Patek

Application Form Review

The members of the Committee requested that the staff add to the application form the name of the

current employer.



24

Case No. 20201492

The Committee requested additional information on this case.

LAW ENFORCEMENT ADVISORY REPORT


1. M.A. – Approved the release of the documents

2. 20200947 – Approved a Public Order of Completion

WELLNESS COMMITTEE


PHP Report

Ms. McCown and Dr. Early provided the Board an update on cases with the PHP.

Non-Interview Matters

Review of FSMB “Policy on Physician Illness and Health: Mitigating Risk and Encouraging

Treatment.” The Committee will recommend to the Board that the report was well written and no

suggestions for changes.

The staff will follow up with the request for materials to be sent to the North Carolina Board.

• NB, MD – license lapsed 2/28/19

The staff will reach out to Dr. Steinberg and see if he is available for an interview in January.

• PS, MD – requested an interview 12/5/19 – ALS Diagnosis

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

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

20201348 FINV 20200017 FINV

20192412 Table 20201651 Close

20201656 AG 20200034 Close

20200659 Close 20201217 LOC

20200275 Close

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

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

Close:

20190606 20191974 20200089 20200237 20200399 20200472

20200780 20200973 20201145 20201175 20201459 20201511



25

20201547 20201610 20210042 20210045 20210066 20210068

20210073 20210106 20210114 20210118 20210155 20210237

20210239 20210244 20210245 20210251 20210255 20210258

20210260 20210262 20210263 20210264 20210265 20210281

20210285 20210295 20210296 20210307 20210309 20210311

20210318 20210320 20210326 20210328 20210333 20210334

20210338 20210340 20210345 20210350 20210360 20210369

20210374 20210379 20210382 20210383 20210388 20210390

20210392 20210393 20210398 20210399 20210404 20210408

20210410 20210417 20210419 20210425 20210434 20210468

20210476 20210495 20210257 20210130 20210337

Close with Letter of Concern:

20200998 20201607 20210269 20210312 20210365 20210407

20210440

Invite for Investigative Interview:

20192386 20192388 20200130 20200521 20200931 20201014

20201111 20210099 20210100 20210317 20210380 20210418

20210431 20210442

Further Investigation:

None

Table

20192103 20200687 20201420 20210386

Attorney General’s Office

20181081 20182007 20200784

Peer Review

20200130 20200521 20200931 20201111 20210099 20210100

20200299 20210236 20210275

OMPE

NONE

INITIAL COMPLAINT EVALUATIONS The Board approved the following recommendations.

20201113 20201114 20201115 20201207 20210381 20210501

20210558 20210564 20210425



26

RECUSALS DeLoach 20192386 20192388 20210236

Marshall 20200275

Norman 20200687

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

meeting at 5:05p.m.

__________________________________ ________________________________

Barby J. Simmons, DO LaSharn Hughes, MBA

Chairperson Executive Director

Recorded by:

________________________________________ Phyllis White, Executive Assistant

georgia composite medical board minutes of the december 3

Documents