GEORGIA COMPOSITE MEDICAL BOARD · The Georgia Composite Medical Board ... Assistant Medical Director William Butler, MD, Medical Director ... Franklin, Samuel George 77737

Georgia Composite Medical Board

Minutes of the April 6-7, 2017 Meeting

1

The Georgia Composite Medical Board (GCMB) held its regular meeting on April 6-7, 2017 at Mercer University Savannah Campus, 1259 East 66th Street Savannah, Georgia to consider Medical Board matters. Board members present: John S. Antalis, MD, Chair E. Daniel DeLoach, MD, Vice Chair Keisha Callins, MD, MPH Gretchen Collins, MD Alexander S. Gross, MD by Teleconference J. Jeffrey Marshall, MD David Retterbush, MD Barby Simmons, DO Ronald “Ronnie” Wallace, MBA Board Members Absent: John Downey, DO Charmaine Faucher, PA-C (ex-officio) B. K. Mohan, MD Joe Sam Robinson, MD Richard Weil, MD

Management and legal staff present: Bob Jeffery, MBA, Executive Director Carl Bedingfield, MD, Assistant Medical Director William Butler, MD, Medical Director Briana Fry-Jones, Executive Administrative Assistant Karl Reimers, Director, Investigations & Enforcement Patricia Sherman, Enforcement Manager Janet Wray, Senior Assistant Attorney General David Stubins, Senior Assistant Attorney General

CALL TO ORDER Dr. Antalis called the meeting of the Georgia Composite Medical Board to order at 8:40 a.m. AGENDA AND MINUTES Dr. Wallace submitted a motion, seconded by Dr. Retterbush, to approve the agenda of the April 6-7, 2017 meeting. The motion carried unanimously. Mr. Wallace submitted a motion, seconded by Dr. Retterbush, to approve the minutes of the March 2017 meeting and the amended January 2017 minutes. The motion carried unanimously. CHAIR’S REPORT Dr. Antalis thanked Mercer School of Medicine for its continued hospitality and willingness to host the Board’s meeting at the beautiful Savannah Campus this month. He also thanked Briana Fry-Jones and the Board staff for working with Dr. Bob Shelley and his staff to put this offsite meeting together. Bill Bina gave welcoming remarks. Mr. Wallace offered a motion to go into closed session to discuss confidential enforcement and investigation matters seconded by Dr. Marshall, and it carried unanimously.



2

LEGAL / ENFORCEMENT ACTION REPORT Mr. Reimers presented the Legal / Enforcement Action Report. Dr. Retterbush submitted a motion, seconded by Mr. Wallace, to accept the report. The motion carried unanimously. The Board took the following actions:

1. Fred Potts, MD - Personally appear for petition

2. Sudhindra Anegundi, MD - Terminate Public Consent Order

3. 20170881 - Release copy of licensure application

4. 20130570 - Release copy of investigative file

5. Brent Austin Wilson, MD - Terminate Summary Suspension

6. 20121132 - Extended deadline for PLAS

7. 20162325 - Denied request

8. 20161620 - Accept Private Consent Order

RECESS Dr. Antalis declared the meeting in recess for the purpose of holding committee meetings. RECONVENE Dr. Antalis reconvened the meeting Friday April 7, 2017 at 8:00 am LICENSURE COMMITTEE Dr. Retterbush presented the Licensure Committee report as a motion. The motion was seconded by Dr. DeLoach. The Board accepted the report by unanimous vote. The Board took the following actions: Other Business: 1. Jason Turner - Deny request to allow CODA (Commission on Dental Accreditation) for Dr. Pirgousis to be granted licensure and advise MCG to consider the Institutional License GA §43-34-33 2. Shabir Ahmadzia - Inform him that an individual physician with an Administrative License who seeks to practice medicine under an unrestricted license shall submit an application to the Board pursuant to Rule 360-2-.15 3. Staff question - Mayo graduate education Form A accepted as processed by the program.



3

4. PI – Table 5. SS - Approved request to sponsor him for SPEX. AG’s office will draft a letter to him re reinstatement. 6. DD – Invite for interview. 7. CN – Invite for interview. 8. GR – Invite for interview. 9. Table Approved Applications Reinstatement Applications: Name License# Chahine, Assaad Alfred 41751 Carr, Aaron David 62665 Gabbard, William Alexander 64935 Herrick, Richard Thomas 47604 Olejeme, Kelechukwu Anne 61307

Approved Educational Training Certificate: DELGADO, GREGG DO

Applications Approved Pending additional Information: CHUKWU, KENDALL REYES UMPIERREZ, DAVID TAVAREZ, MARINO DE JESUS TAYLOR, MELBA

Approved Applications for Licensure Name License# Agarwal, Vijay 77695 Agochukwu, Kendall Denise 77694 Akce, Mehmet 77696 Al-Bayati, Alhamza 77697 Anastasi, John S 77869 Anderson, Shenique 77698 Araim, Leheb Hisham 77699 Aumann, Waitman Kurt 77700 Ayanga, Daniel Oluwaseun 77701 Baran Akce, Leyla 77872 Belan, Matthew 77702 Bell, Timothy Vernon 77778



4

Name License# Beras Jovine, Maximo Ramon 77703 Berg, Jeremy Scott 77704 Bhasin, Arpita Kadakia 77705 Bilgutay, Aylin 77706 Bingham, Tia 77781 Bird, Juan C 77707 Blanchard, Rachel 77708 Bohner, Brian 77865 Bowers, Robert Lawrence 77709 Brock, Robert Christopher 77710 Byku, Isida 77711 Carr, Devon Alexander 77712 Carroll, Catherine Vera 77713 Chavez-Frazier, Arianne Elizabeth 77714 Chen, York 77715 Choksi, Nishit A 77776 Christ, Ashley Elizabeth 77716 Christenbury, Joseph Gill 77717 Crim, Matthew Tyler 77718 Crockett, Keirsun 77719 Cutrone, John Anthony 77720 Dalsania, Ami 77721 Daniels, Lisa 77722 Demetrios, Meena 77782 Depaolis, Dion Carlo 77784 Devapriya, Inoka Abeysiri 77723 Dinh, Faustine Luu 77724 Dominguez Diaz, Dora Patricia 77725 Douglas, Darrel 77726 Downey, Douglas Merritt 77727 Downie, Gordon Hunter 77868 Driscoll, Ian 77728 Dunn, Cary Leo 77729 Elbon, Megan Marie 77873 Elliott, Trenton Chase 77870 Esho, Kenny Harris 77730 Farnum, Elisabeth Knight 77731 Fawehinmi, Olajide 77732 Fay, Laura Stubbs 77733 Filev, Peter 77734 Folan, Thomas Naughton 77735



5

Name License# Fox, Brianna 77736 Franklin, Samuel George 77737 Frundi, Lum Tina 77738 Garg, Akshay Sen 77739 Garg, Reena Akshay 77740 Gay, Allison Buterbaugh 77741 Giles, Candace 77742 Gill, Sarah 77743 Gizinski, Alison Michelle 77744 Glass, Oliver Mathew 77745 Goltzer, Oren 77746 Gorman, Ann Elizabeth 77747 Greer, Gillian Averee 77748 Gusching, Justin 77750 Gutman, Colleen Kays 77749 Hamilton, Julius Erving 77826 Hammond, Joshua Taylor 77828 Hansra, Damien Mikael 77829 Hardy, Matthew Edward 77830 Harris, Jonathan Scott 77824 Hartridge, Caroline Lucille 77831 Hollis, Minoo H 77832 Iacob, Codrin E 77879 Jackson, Toni 77822 Jaffe, Helaina 77833 Jaffree, Layla S 77834 Jahraus, Joel Patrick 77835 Jain, Amit 77836 Joshi, Gagandeep K 77837 Junaidi, Babar 77838 Kamath, Ashvin 77874 Kantor, Jonathan 77827 Kashlan, Osama N 77821 Keen, Ryan James 77839 Kelley, Janet 77840 Kilbourne, Michael 77825 Kneeland, Misty 77841 Kollepara, Sri Lakshmi Sudha 77842 Krishna, Abhishek 77843 Krook, Kaelyn 77844 Kuhn, Lydia Joy Dr 77866



6

Name License# Kumbla, Rekha Anjali 77845 Lawrence, Jessie Barton 77846 Levy, Sara 77848 Lewis, Irwin 77847 Lundy, Michael Stephen 77849 Macian, Diana Maria 77877 Manos, Cynthia Kaiser 77850 Maqbool, Maaz Sohail 77851 Martinez, Cecilia Isabel 77854 Masters, James Edward 77853 Matthews, Gary Eugene 77862 Mccollough, Andre 77876 Mcdevitt, Brianna Shay 77855 Mcphillips, Kristin 77867 Mididoddi, Prathyusha 77878 Mikosz, Christina 77823 Minkhorst, Olivia Rose 77858 Modi, Haresh 77856 Mostert, Monique 77859 Narducci, Carl 77852 Natarajan, Neela 77875 Neymotin, Arie 77857 Ng, Chi-Kin 77860 Olarewaju, Ayodeji 77861 Padala, Sandeep Anand 77751 Pantangi, Pramod 77752 Park, Yeonjung 77753 Patel, Neal 77754 Patel, Rutvi 77755 Patel, Sunil Jayavanr 77756 Pokharel, Sajal Sharma 77757 Ponnusamy, Karthikeyan 77758 Postigo Jasahui, Maykol 77759 Pouch, Stephanie Marie 77760 Praprotnik, Darja 77761 Raman, Vinod 77762 Rasiwala, Insiya 77763 Razdan, Rishi Norman 77764 Reuben, Sharon 77765 Ricketts, John Carmichael 77864 Rogers, Ryan W 77766



7

Name License# Rose-Felker, Kirsten F 77767 Rosemblat, Aldo 77871 Sadowsky, Jeffrey A 77768 Samo, Salih 77769 Sarbu, Joseph Cristian 77770 Schosheim, John Paul 77771 Schuler, John 77772 Shah, Jehan L 77773 Shannon, Timothy J 77774 Shapiro, Mark Louis 77775 Shehu, Nabila 77777 Siddiqui, Mahmood Abdul Qadir 77779 Sikod, Anna Moiwo Kuo 77780 Simmons, Dylan 77863 Singareddy, Ravi Kumar Reddy 77783 Skillman, Sarah 77785 Sklyar, Tatyana Yurievna 77786 Smith, Benjamin Parker 77787 Soliman, Noha Raouf 77788 Sommerfeld, Casey 77789 Sorensen, Matthew Wayne 77790 Sou, Caroline Aram 77791 Suh, Yong Duk 77792 Sutton, Danielle Baskin 77793 Taylor, Gregory Warwick 77794 Taylor, Katherine Porter 77795 Theegala, Rama Lakshmanarao 77819 Tinnin, Megan Elizabeth 77796 Tran, Khoa D 77797 Tran, Stephanie Mai 77798 Turner, Rege 77799 Uddin, Sabrina Uddin 77800 Usman-Oyowe, Ibrahim Atsejuwawe 77801 Valenciano, Sandra Johanna 77802 Vetrano, Nicholas 77803 Vickers, Joshua Landon 77804 Walker, Turkessa Jenarda 77805 Wallace, Lucy Brooks 77806 Wallis, Denise Desiree 77807 Washington, Diane 77808 Wechsler, Elena 77809



8

Name License# Wees, Nabil 77810 Whitley, Jeremy Darnell 77811 Wills, Delinda D 77812 Winn, Brian Thomas 77813 Woloszyn, Jakub 77814 Woodall, Michael Neil 77815 Wright Mayes, Emily 77816 Yadgarov, Arkadiy 77817 Yalamanchili, Rajesh 77818 Zeinaty, Ibrahim A 77820

NURSE PROTOCOL COMMITTEE Dr. Callins presented the Nurse Protocol Committee report as a motion. The motion was seconded by Dr. DeLoach. The Board accepted the report by unanimous vote. The Board took the following actions: The Board determined that the following protocol agreements meet the provisions of OCGA 43-34-25: APRN DELEGATING PHYSICIAN Blalock, Jamie Quigley, Debora MD Bryant, Allison Manahan, Kelly MD Burgamy-Stevens, Cindy Behlmann, Joshua MD Jha, Shashank Soltero, Augusto MD Johnson, Jessica Ditaranto, Anthony MD McBrayer, Melanie Shashidharan, Subhadra MD Mcmillan, Lauren Slaughter, Chad MD Mena, Jorge Al-Hakim, Ayman MD Nickelson, Regina Dekar, Amit MD Nickelson, Regina Mitchell, Bruce MD Pihera, Rebecca McNulty, Darlene MD Rosenberg, Kayla Raju, Shveta MD Rotella, Melissa Levy, Joshua MD Saulsby-Smith, Amy Patel, Shailesh MD Scott, Amy Justiniano-Ayala, Jose MD Shapin, Melanie Sashidharan, Subhadra MD Smith, Deborah Quigley, Debora MD Stephan, Karen Shashidharan, Subhadra MD Tucker, Tiffany Wood, Karen MD Young, Kimberly Graham, Yolanda MD



9

Administrative Approvals: APRN DELEGATING PHYSICIAN Anderson, Kymberly Singh, Harsh MD Bell, Joann Richmond, John MD Bentley, Bentley Phelphs, Shean MD Bishop, Leslie Sallee, Denver MD Cassell, Krista Peters, Charles MD Clark, Leila Miranda, Paul MD Clark, Leila Wilson, Michael MD Clifton, Katelyn Miller, Thomas MD Conway, Valerie Pohl, Stephen MD Conway, Valerie Pohl, Stephen MD Cook, Erin Whipple, Robert MD Dees, Krista Pimanova, Elena MD East, Missy Daugherty, Michael MD Follmer, Diane Huque, Ehteshamul MD Gaskins, Margo Rios-Coruju, Walter MD Hughes, Julee Geary, Brian MD Jones, Kelly Haynes, Gaye MD Jones, Yolanda Taylor, Colleen MD Kiser, Kenneth Graham, James L Latham, Tiffany Floyd, Jay MD Lawrence, James Richardson, Eddie MD Mason, Patricia Ajakaiye, Wallace MD Mathis, Lauren Polimenakos, Anastasios MD Mckenzie, Shariah Kwarteng, Francis MD Middleton, Travis Prastik, Eric MD Mitchell, Aundre Deal, Eric DO Moore, Ayjanah Shear, Ryan DO Moss, Taylor Mchayleh, Wassim MD Orange, Barbara Cox, David MD Paris, Kimberly Sawyer, Horace MD Patel, Amber Coleman, Teresa MD Patti, Farrah Stovroff, Mark MD Perkins, Nekey Prasatik, Erik MD Polk, Stephanie Shaw, Eric MD Pope, Lori Prasad,Sarita MD Stively, Deborah Headley, William MD Bush, Michayla Dinelle, Kenneth MD Hatcher, Katherine Hutchins, Julian MD Hosckstedler, Marita Noble-James, Candi MD



10

Acree, Lisa Delgado, Reden MD Lambeth, Lauren Vaugh, Mary MD Gee, Kayla Hsine, Grant MD Little, Morgan Martin, Greg MD Clarke, Kendall Morgan, Sidney MD LaCombe-Davis Foushee, Karen MD Lewi, Jacqueline Crawford, Marvin MD Young, Beth Garrison, Joel MD Banks, Kai Arora, Vijay MD Blasche, Joel Kho, Brain MD Blasche, Joel Cox, Robert MD Booth, Penny Lang, Joshua MD Cafarelli, Andrea Onwuanyi, Anekwe MD Canzon, Kenneth Kenney, Jeffrey MD Caua, Mark Kaldas, Eman MD Combs, Jenna Haugabrook, Anita MD Curry, Brittany Brady, Alford MD Darnell, ,Lauren Brown, Craig MD Demott, Jennifer Bhatti, Babur MD Demott, Jennifer Dass, Manoj MD Deweese, Vickki Beckner, John MD Dunkley, Tanya Bhuiyan, Iffat MD Foston, Tenita Crocker, Bobby MD Garretson, Margaret Kacsoh, Gabriella MD Garrison, Margarita Ghose, Manjushree MD Gephart, Rebecca Dinatti, Louis MD Grulke, Charlotte Hari, Meenakshi MD Harriet, Cadle Snell, William DO Hedden, Danielle Babka, Ildiko MD Hodo, Michael Little, Leonard MD Irions, Autumn Ross, Jack MD James, Melochy Cangiano, Jose MD Knight, Kevin Bramhadevi, Srinvas MD Konieczka, Carl Eagleson, Patrick MD Lee, Amanda Edwards, Tania DO Lee, Knicole Cezar, Teresa MD Lee-Gregory, Antoinette Brown, Timothy MD Lomax, Susan Greenberg, Wendy MD Nobles, Mary Brown, Marcus MD Rylee, Alexis Ayham, Haddad MD



11

The Board determined that the following protocol agreements meet the provisions of OCGA 43-34-25 with additions/changes: APRN DELEGATING PHYSICIAN Pugmire, Karen Wyrzkowski, Amy MD Porter, Surrell Parti, Ashna DO Paulk, Jane Bailey, Bridgett DO Sarpkaya, Nuriye Bowman, Mac MD Montes, Marie-Daniel Markham, David MD Moses, Karen Spellman, Allison MD Parker, Gail Snell, William MD Chambers, Brittany Lynch, Lori MD Diller, Jeffrey Brandigi, Claus MD Elllis, Kyndra Dingle, Bridgette MD Grall, Tina Spinolo, Jorge MD Grall, Tina Patel, Sheetal MD Grall, Tina Ummed, Kamal MD Kalen, Jennifer Wellons, Eric MD Kennedy, Sheryl Van Horn, Andrew MD Lee, Jamie Del Pozo, Robert MD Markwater,Gena Hogan, Christopher MD Maschinot, Eve Mitchell, Bruce MD Matey, Andrew Co, Carter MD Other Business: 1. HB 242- Information Only Approved Additional Procedures: 1. Kerri Whittenburg w/ Dr. Raymond Howard: nosopharyngoscopy flexible laryngoscopy nasal endoscopy cerumen removal under microscope 2. Amber Oglesby w/ Dr. Byron Williams III: stress tests 3. Emily Shah w/ Dr. Mark El Deiry: flexible fiberoptic laryngoscopy endoscopy with nasopharyngedl open incisional biopsy of the head and neck fine needle aspiration tracheostomy decannulation



12

PHYSICIAN ASSISTANT COMMITTEE Dr. Antalis presented the Physician Assistant Committee report as a motion. The motion was seconded by Dr. Callins. The Board accepted the report by unanimous vote. The Board took the following actions: Approve the following applications for initial licensure with a supervising physician:

Name License# Supervising Physician Anderson, Shelley Marie 8319 Hodge, Juvonda Craig, Joseph Matthew 8320 Goldman, Marc Croft, Justin 8321 Hunter, Timothy Davis, Amber Marie 8322 Johnson, Julie Lynae Desai, Nirali Bharat 8323 Palmore, Melody Lakic, Andreja Branislav 8324 Moody, Rodney Rector, Meagan 8325 Dega, Sreevalli Van Duys, Heather Rose 8335 Fox, Charles A. Worley, Rebekah 8326 O'Brien, Stacey Young, Jennifer Ellen 8327 Poag, Joyce

Approved the following applications for initial licensure without a supervising physician: Name License# Dunoff-Romero, Elliot Luis 8328 Edwards, Shorn Randolph 8329 Langohr, Megan 8331 Phelps, Kenneth Richard 8330 Piper, Holland 8332 Reed, Vincent John 8333 Taylor, Marcia Danielle 8334

Approved the following applications for reinstatement of licensure: Name License# Supervising Physician Cobbs, Jennifer Coleman 4537 Coleman, John Hersch, Thomas Elliot 5859 Magnet, Andrew Jones, Djifa Richards 4547 Blair, Fiona

Approve the following requests for additional duties: PA Supervising Physician Negin Bauer PA-C Jack Chen, MD Cardiac stress testing, exercise and pharmacologic



13

Approve the following Add/Change applications: PA Supervising Physician

Bailey, Wilhmenia Miller-Thrasher, Melinda Banya, Markeita Kimes, Damon Baugham, Joe Toman, Jared Bayani, Laura Lopez-Armstrong, Ciela Beck, Jessica Kleiman, Richard John Benz, William Mohsen, Akhlaghi Bloodsaw, Lashonda King, Joshua Alexander Casanova, Pedro Richman, Daniel Dare, Timothy Roarty, Joseph Dickerson, Annette Oyler, Jeffrey John Dozier, Rhonwynn Johnson, Anita Eckert, Jacqueline Mackay, Gregory Edwards, Morgan Elizabeth Page, Andrew Joseph Elder, Torra Benson, Elimor Erusiafe, Kevwe Cox, Cristalle Everett, Sarah Katherine Currier, Heather Mc Ginnis Ewing, Mary Clare Santora, Albert Farrior, John Soriano, Floyd Fox, David Duckett, James Freeman, Leslie Smith Eppihimer, Lindsay Carol Gordon, Landis Coffee Munro, Ian Gusick, Reena Taank Kazimi, Marwan Guthrie, Clayton W Brooks, William White Hagerman, Patricia Kohli, Hira Hartsfield, Traci L Lawless, Terri Elizabeth Hedrick, James Joshi, Manishkumar Heyer, Michael Joshi, Manishkumar Howell, Dawn C Oommen, Ronnie Tom Jennings, Donna Lee, Joon Johnson, Maureen Floyd, Jay Jones, Erin Ford, James Jones, Whitney David, Dion King, Karl B Buelvas, Raul Salvador Liebel, Sara Griggin,Joseph Lowry, Elizabeth Fackler, William Mann, Erikaa Lauren Smith, Jimson Okon Miller, Kyle M Harper, Kenneth Earl Pass, Kristin Rekaby, Vafa Peterson, Eric Louis Siciliano, Michael Anthony



14

Queen, Haley Beth Whisenhunt, Anumeha Kumar Reed, Kristen Karoline Cooper, Jerry Lee Saunders, Gregory Patel, Hemal Vasantrai Sears, Shelley Dell'aglio, Damon Michael Md Shetty, Danna Wheeler, James Henson Short, Dennis James Lawson, Dale Morgan Shyr, Jessica Dressander,Jeffry Smarra, Mary Beth Corr, John Price Jr Stephens, Rachel Paige Bhakta, Ashish Tepic, Nermin Patel, Deval U Trahan, Christine Marie Priddy, Bradford Hollace Ward, Amanda Ratz, John Louis Weaver, Roger Osegbue-Obasi, Francesca Chinwe Webb, Kathleen Deep Oyola,Raul West, Erica J Delmas, Emily Rogers

RESPIRATORY CARE COMMITTEE Dr. Collins presented the Respiratory Care Committee report as a motion. The motion was seconded by Dr. Callins. The Board accepted the report by unanimous vote. The Board took the following actions: Approved Applicants requesting licensure by Reciprocity: Name License# Buice, Pierre 10555 Damus, Marlene 10559 Duncan, Ronald Dewayne 10562 George, Tressa Rae 10560 Goodwin, Lanie Lea 10561 Magee, Robin Denise 10554 O'Kelley, Casie Jean 10566 Sherman, Tamra 10558 Smith, Bree 10556 Smith, Jennifer Lynn 10564 Thomas, Santhosh 10563 Villasenor, Dulce 10557



15

Approved the following applicants requesting a 12-month permit: Name License# Bonner, Whitney 10553 Twitty, Tiffany 10565

Tabled: JC Administratively approved up-grades from 12 month permits to full RCP license: ALAMEDA, EVELYN BARRY, CLARISSA BLACKSHEAR, TAQUANA BRYANT, BRITTNEY CARTER, OCTAVIA CLANCE, CALEB COOGLER, KRISTYN DUVALL, KSENIYA GRANT, ADRIENNE HUETHER, SONDRA RENEE KEOWN, WILSON KOPHAZY, TAMARA MALOVE, ADRIAN MCGEE, DAWN MOBLEY, EVAN MOORE, BRIGITTE MOORE, MALLORY MORRIS, THOMAS PARSON, JESSICA SALEH, ABDULKALIQ THAO X, PHAM WAGNER, LAUREN Other Business: Invited Jeffrey Thompson and Douglass Masini to the June Board meeting to interview for the open positions on the RCP advisory committee. COSMETIC LASER PRACTITIONER COMMITTEE Dr. DeLoach presented the Cosmetic Laser Practitioner Committee report as a motion. The motion was seconded by Dr. Retterbush. The Board accepted the report by unanimous vote.



16

The Board took the following actions: Approved the following applications for Assistant Laser License: Name License# Bailey, Angela N 800 Bassett, Deborah 801 Clark-Jenkins, Barbara R 802 Collins, Angela R 803 Cross, Miranda L 804 Dewitt, Sharkina S 805 Dursee, Cherri 806 Hardison, Maha F 807 Johnson, Latrenda 808 Morton, Monica R 809 Preston, Macie M 810 Quang, Bich-Thuy 811 Snow, Angela J 812 Vazquez, Nadia I 813 Williams, Shaniya Latrice 814

Approved the following application for Senior Laser License: Name License# Gladney, Lori E 250 Mcallister, Allie M 251

PAIN MANAGEMENT CLINIC COMMITTEE Dr. Retterbush presented the Pain Management Clinic Committee report as a motion. The motion was seconded by Dr. DeLoach. The Board accepted the report by unanimous vote. The Board took the following actions:

Initial Applications Approved for Licensure File # Pain Clinic Name

417 Ancora Pain Recovery – Dublin

419 Atlanta Spine and Anesthesia 423 Harbin Clinic, LLC – Cartersville 416 North of Atlanta Pain Clinic - Duluth 424 Pain Care, LLC – Johns Creek – received background checks



17

420 Comprehensive Spine & Pain, LLC – Lithia Springs 422 Hemlock Pain Center, LLC – Dublin

Invite for interview:

418 A. LLC The following applications that were Administratively Approved

License # Pain Clinic Name

368, 369

Axis Pain Center Delete Managing Employee Patricia Riggs Add Managing Employee, Charles Schofill

320

Physicians Institute for Pain Management Delete APRN Barbara Pearce Delete APRN Windy Giddens

155 Georgia Pain and Wellness Add APRN: Erwin Cruz

326 Alliance Spine and Pain Center Add Practicing Physician Myrlynn Delille, MD

313,314 Pain Care, LLC Add Practicing Physician Carlos Pulido, MD

225,226,227

Pain Management Specialist of Atlanta Add APRN Surrell Porter (APRN Agreement going to April 6, 2017 APRN Committee Meeting)

234, 291 Specialty Clinics Spine Intervention Add APRN Sara Lesley

235

Specialty Clinics Spine Intervention Revise Business Hours Add Practicing Physician Leena Lake, MD Add Practicing Physician Howard Robinson

Other Business: 1. Refer the reinstatement rules be sent back to the Rules Committee for additional work. J. David Stubins, Senior Assistant Attorney General will work with the Rules Committee on the verbiage for the reinstatement. 2. Reviewed changes to the Reinstatement Application’. 3. Reviewed and discussed the Pain Clinic Renewal Application and made no changes. ACUPUNCTURIST COMMITTEE



18

Dr. Antalis presented the Acupuncturist Committee report to the Board. Dr. DeLoach motioned to accept the report. Dr. Retterbush seconded the motion. The Board accepted the report by unanimous vote. The Board took the following actions: Approved application for Limited Licensure Name License# Wilson, Rachel 401

Approved applications for Initial Licensure Name License# Sherrell, Eric A 402

Upgraded from Limited to Full License: Name License# Lee, Michelle Seong Hi 388

Other Business:

1. Approved--John Albright—requested a three-month extension to complete supervisory practice.

2. Reviewed as information – the list of limited licensees and supervisors. RULES COMMITTEE Dr. Gross presented the Rules Committee report as a motion. The motion was seconded by Dr. Callens. The Board accepted the report by unanimous vote. The Board took the following action: Posted Rule 360-37, “Military Spouses and Transitioning Service Members Licensure”, for public comment at hearing scheduled for June 9, 2017. ATTORNEY GENERAL’S REPORT Mr. Changus, Assistant Attorney General, updated the Board on the status of matter that have been referred to the Attorney General for legal action. Dr. Retterbush submitted a motion, seconded by Dr. DeLoach, to accept the report. EXECUTIVE SESSION



19

Dr. DeLoach submitted a motion, seconded by Dr. Retterbush, to go into executive session to discuss investigative matters. Dr. Antalis declared the meeting in open session. WELLNESS COMMITTEE Dr. Collins presented the Wellness Committee report. Dr. Downey submitted a motion, seconded by Dr. Deloach, to accept the report. The Board accepted the report by unanimous vote. The Board took the following actions: 1. PHP report received from Paul Earley, MD. 2. 20120408 – Termination of Private Consent Order granted. 3. 20110724 - Termination of Private Consent Order granted. 4. 20131126 – Doctor must adhere to the Order and complete four hours of Ethics CME per year. 5. M.D. – Asked to provide his request for monitoring in writing. INVESTIGATIVE INTERVIEW REPORT

E. Daniel DeLoach, M.D. presented the Investigative Interview report as a motion, and was seconded by Keisha Callins, M.D. The Board accepted the report by unanimous vote.

The Board took the following actions.

20160825 Close/No Action 20162401 Table 20162489 Close with Letter of Concern

INVESTIGATIVE COMMITTEE The Investigative Committee report was presented as a motion by J. Jeffrey Marshall, M.D., and was seconded by David Retterbush, M.D. The Board accepted the report by unanimous vote.

The Board took the following actions.

Close:

20130418 20141092 20150421 20150987 20151366 20160271 20160853 20160854 20160890 20161022 20161984 20162149 20162154 20162248 20162387 20162407 20162421 20162424 20162453 20170012 20170088 20170099 20170121 20170176 20170203 20170250 20170275 20170285 20170358 20170384 20170476 20170483 20170494 20170572 20170583 20170605 20170611 20170663 20170666 20170677 20170685 201707120 20170761 20170772 20170788 20170817 20170839 20170845



20

20170878 20170921 20170928 20170934 20170954 20170955 20170957 20170964 20170967 20170988 20170993 20170995 20171006 20171007 20171025 20171036 20171037 20171052 20171053 20171054 20171060 20171062 20171063 20171070 20171080 20171082 20171085 20171086 20171090 20171092 20171097 20171099 20171102 20171111 20171116 20171121 20171122 20171128 20171130 20171132 20171147 20171155 20171159 20171347 20171425 20171468 20171564 20171570

Close with Letter of Concern:

20162426 20170283 20170286 20170555 20170632 20170729 20170777 20170785 20170787 20170870 20170907 20170943 20170946 20170947

Invite for Investigative Interview:

20130671 20161491 20161780 20170188 20170219 20170232 20170259 20170283 20170440 20170525 20170633 20170751 20170955 20171024 20171113 20171119 20171129

Table

20150863 20170177 20170026 20170178 20170347 20170423 20170425 20170435 20170440 20170587 20170854 20171341

OMPE

20161239 20170011 20170287

Mirror Action from Other State

20162441

Attorney General’s Office

20161520 20162419

INITIAL COMPLAINT EVALUATIONS

The Board approved the following recommendations.

20171301 20171304 20171310 20171314 20171359 20171365 20171381 20171393 20171396 20171512 20171513 20171523 20171525 20171534 20171541 20171544 20171548 20171552 20171563 20171575 20171577 20171578 20171586 20171588 20171590 20171592 20171606 20171609 20171613 20171617 20171620 20171624 20171627 20171634 20171636 20171638 20171639 20171640 20171646 20171657 20171658



21

RECUSALS

Collins 20162272

DeLoach 20161984 20170583 20170623 20170817 20171036 20171060 20171090 20171097 20171111 2071132

Marshall 201704025 20170988 20171155

Retterbush 20161780 20170012 20170219

There being no other business, Dr. DeLoach submitted a motion, seconded by Dr. l, to adjourn the meeting. The motion carried unanimously. Dr. Antalis adjourned the meeting at 5:15 pm. ___________________________ __________________________________ John Antalis, MD Robert Jeffery, MBA Chairperson Executive Director Recorded by Diane Atkinson

Documents

GEORGIA COMPOSITE MEDICAL BOARD · The Georgia Composite Medical Board ... Assistant Medical Director William Butler, MD, Medical Director ... Franklin, Samuel George 77737