Arizona Medical Board - azmd.gov

1 FacilityLictypeLicense Num LicenseeStatusStart DateEnd Date1908R75713 Charaffedine Ali Active03/05/201803/30/2018 Abrazo Central Campus1908R75844 Agha Ahmed KM Active07/01/201706/30/20181908R75845 Amurao Miguel Carlo Active07/01/201706/30/20181908R76421 Bierny Philippe Joseph Active07/01/201706/30/20181908R75298 Donaldson Janelle Evans Active07/01/201706/30/20181908R75847 Gonzales Miguel Roberto Active07/01/201706/30/20181908R76074 Havard Lauren Lehne Active07/01/201706/30/20181908R75297 Hayes Kellen Joseph Active07/01/201706/30/20181908R75296 Okafor Mark Chukwuamaka Active07/01/201706/30/20181908R75295 Park Dalnam Active07/01/201706/30/20181908R75848 Raad Kareem Naji Active07/01/201706/30/20181908R75849 Rechul Dawid Robert Active07/01/201706/30/20181908R75846 Rechul Kisria Ann Active07/01/201706/30/20181908R76075 Speirs Shane Ryan Active07/01/201706/30/20181908R76320 Veliz Pablo Nicholas Active07/01/201706/30/20181908R76321 Vieira Renato Monteiro Active07/01/201706/30/20181908R75293 Von Detten Tanya Kalani Active07/01/201706/30/20181908R76076 Wong Christina Pui-Yunn Active07/01/201706/30/20181908R75850 Zhang Jing Qian Active07/01/201706/30/20181908R75294 Zweig Matthew Sterling Active07/01/201706/30/2018 College of Medicine.

2 Mayo Clinic1908R75872 Abdel-aty Yassmeen Active07/01/201706/30/20181908R74602 Abdul Muhsin Haidar M Active07/01/201706/30/20181908R75554 Adler Cameron Robert Active07/01/201706/30/20181908R75563 Agasthi Pradyumna Active07/01/201706/30/20181908R76315 Aguilar Maria TheresaActive07/01/201706/30/20181908R75 335 Allen Sorcha Active07/13/201707/12/20181908R75256 Arca Karissa Nicole Active07/01/201706/30/20181908R76264 Arthur Jaymeson Ray Active07/01/201706/30/20181908R76396 Aston Jeffrey William Active07/01/201706/30/20181908R74696 Atwal Danish Active07/01/201706/30/20181908R75861 Babb Benjamin Albert Active07/01/201706/30/20181908R76570 Basu Arpita Active03/10/201804/01/2018 Page Number 1 of 47 Arizona Medical BoardFacilityLictypeLicense Num LicenseeStatusStart DateEnd DateCollege of Medicine, Mayo Clinic1908R76401 Behbehani Sadikah F A A A.

3 Active07/01/201706/30/20181908R76285 Bergman Daniel Joseph Active07/01/201706/30/20181908R75862 Bering Jamie Lauren Active07/01/201706/30/20181908R75673 Bettini Layne Mauro Active04/02/201804/01/20191908R75058 Bhangoo Ronik Singh Active07/01/201706/30/20181908R75879 Blech Benzion Chaim Matthew Dennis Active07/01/201706/30/20181908R76397 Calderon Saa Jaramillo Rachel Elizabeth Active07/01/201706/30/20181908R76278 Carnahan Molly Brent Active07/01/201706/30/20181908R76276 Carolan Alexandra Maria Chia-Chun Active07/01/201706/30/20181908R76253 Davis Amy Darlene Active07/01/201706/30/20181908R76250 Davis Ralph Gordon Active07/01/201706/30/20181908R75751 Dawit Sara Active07/01/201706/30/20181908R75856 Delafield Nathan Lechae's Active07/01/201706/30/20181908R76558 Dell Emily Anna Active03/28/201804/25/20181908R75858 Dhanik Arjun Active07/01/201706/30/20181908R75908 Escamilla Andrew Active12/12/201703/09/20181908R76277 Faraj Kassem Samer Active07/01/201706/30/20181908R76564 Finch Alexander Stuart Active03/10/201804/06/20181908R75778 Fleck Andrew Ryan Active07/01/201706/30/20181908R75424 Giorgakis Emmanouil Active07/01/201706/30/20181908R76578 Goel Sangita Active04/07/201805/04/20181908R75873 Hall Scott Ryan Active07/01/201706/30/20181908R76281 Hammond Jacob Benjamin Active07/01/201706/30/20181908R76554 Hanley Bernadette Mary Active01/09/201807/09/20181908R74600 Hansen Daniel Alexander Active07/01/201706/30/20181908R76557 Harper Lauren Shiaoling Jeffrey Dalton Active07/01/201706/30/20181908R75877 Hill Hannah Elizabeth Active07/01/201706/30/20181908R75790

4 Hoffman Laura Ann Active07/01/201706/30/2018 Page Number 2 of 47 Arizona Medical BoardFacilityLictypeLicense Num LicenseeStatusStart DateEnd DateCollege of Medicine, Mayo Clinic1908R75792 Hopp Alix Chen Active07/01/201706/30/20181908R75863 Horsley Robert Kenneth Active07/01/201706/30/20181908R76286 Huber Jordan Talmage Active07/01/201706/30/20181908R76262 Jackson Niki Rose Active07/01/201706/30/20181908R76287 Jackson William Taylor Active07/01/201706/30/20181908R76451 Jain Varun Active07/01/201706/30/20181908R75875 Jamison Dale Kenneth Active07/01/201706/30/20181908R76292 Jogerst Kristen Michelle Active07/01/201706/30/20181908R76586 Johnson Stephen Abraham Active05/07/201805/31/20181908R75936 Jones Derick David Active04/01/201703/31/20181908R76589 Kaleem Tasneem Akthar Active04/02/201804/27/20181908R76556 Kassi Mahwash Active02/12/201803/09/20181908R76251 Kasule Sabirah Nakakande Active07/01/201706/30/20181908R76531 Kenevan Melissa Rae

5 Active01/22/201703/09/20181908R76565 Khalil Charl Atef Nassef Active01/30/201803/09/20181908R75960 Khoury Nadeen Active03/13/201703/12/20181908R76288 Knox Molly Gay Active07/01/201706/30/20181908R76466 Kohli Divyanshoo Rai Active07/01/201706/30/20181908R76312 Kumar Anjushree Active07/01/201706/30/20181908R75866 Lacy Curtis Ray Active07/01/201706/30/20181908R76254 Lai Kin Chung Active07/01/201706/30/20181908R75101 Lara Nina Jeanette Active06/23/201706/22/20181908R76555 Lee Christopher Judge Active01/09/201807/09/20181908R75878 Lehrer Michael David Active07/01/201706/30/20181908R76289 Lim Victoria Melodie Active07/01/201706/30/20181908R75864 Maddux Jacob Tyler Active07/01/201706/30/20181908R75870 Makovicka Justin Lee Active07/01/201706/30/20181908R76282 Malan Shawn Hamilton Active07/01/201706/30/20181908R76546 Mao Shennen Ashley Active02/26/201803/30/20181908R76500 Marin Acevedo Julian Jonathan Active07/01/201706/30/20181908R76291 Meyer Megan Marie Active07/01/201706/30/2018 Page Number 3 of 47 Arizona Medical BoardFacilityLictypeLicense Num LicenseeStatusStart DateEnd DateCollege of Medicine.

6 Mayo Clinic1908R76548 Misal Meenal Anant Active02/20/201803/09/20181908R75853 Molloy Michael John Active07/01/201706/30/20181908R75865 Murad Douglas Alexander Active07/01/201706/30/20181908R74216 Murphy Katie Mary Active07/01/201706/30/20181908R76575 Nabil Muhammad Ahad Active03/13/201804/08/20181908R76255 Nafissi Nellie Niloofar Active07/01/201706/30/20181908R76417 Navaratnam Anojan Kandiah Active07/01/201706/30/20181908R76551 Norgan Andrew Paul Active02/26/201804/13/20181908R73754 Nunez Nateras Rafael Robert Abraham Active07/01/201706/30/20181908R75855 Ornelas Abbie Sabrina Active07/01/201706/30/20181908R76571 Pandompatam Govind Active03/10/201804/06/20181908R76279 Parnall Taylor Hanna Active07/01/201706/30/20181908R75874 Pflibsen Lacey Rachel Active07/01/201706/30/20181908R76316 Rau Jill CamilleActive07/01/201706/30/20181908R75 888 Rayfield Corbin Alexander Active07/01/201706/30/20181908R76249 Renfrew John Granby Active07/01/201706/30/20181908R73756 Rhee Daniel Hyun Kyu Active06/29/201706/28/20181908R75876 Ritz Matthew Lewis Active07/01/201706/30/20181908R75887 Rose Kyle Matthew Active07/01/201706/30/20181908R75429 Saleem Abdulaziz Mamdooh Active08/01/201707/31/20181908R75091 Sattur Mithun Guraraj Active07/01/201706/30/20181908R75334 Scotch Allison Hope Kelly Leigh Active07/01/201706/30/20181908R76284 Seman Mithcell Tim Active07/01/201706/30/20181908R76314 Sharma Akanksha Active07/01/201706/30/20181908R75867 Shipman Justin Neal Active07/01/201706/30/20181908R76562 Skelley Logan Mark Active03/05/201803/30/20181908R75868 Smith Erin Michelle

7 Active07/01/201706/30/20181908R76563 Smith Kelsey Marie Active02/12/201803/09/20181908R75384 Stanich Jessica Ann Active04/03/201704/02/20181908R75562 Stoker Alexander David Active07/01/201706/30/2018 Page Number 4 of 47 Arizona Medical BoardFacilityLictypeLicense Num LicenseeStatusStart DateEnd DateCollege of Medicine, Mayo Clinic1908R75860 Stone Jonathan Brian Active07/01/201706/30/20181908R75282 Stull Lindsey Blair Active07/01/201706/30/20181908R76268 Taylor Cullen Michael Active07/01/201706/30/20181908R76290 Thorpe Cameron Scott Active07/01/201706/30/20181908R76272 Thorwarth Ryan Matthew Active07/01/201706/30/20181908R76585 Tschautscher Craig Franz Active04/07/201805/04/20181908R75869 Tseng Andrew Sean Active07/01/201706/30/20181908R76280 Vaidya Rohan Vilas Active07/01/201706/30/20181908R75305 Valencia Sanchez Cristina.

8 Active07/01/201706/30/20181908R76587 Van Decar Lauren Michelle Active07/01/201806/30/20191908R75881 Wallace Alex LeeActive07/01/201706/30/20181908R75854 Webb Christopher Joseph Active07/01/201706/30/20181908R76569 Weil Erika Layne Active03/12/201804/04/20181908R76313 Whigham Morgan Alexandra Active07/01/201706/30/20181908R76263 Wiedmeier Julia Erin Active07/01/201706/30/20181908R76273Yu Nathan Yung-Chuen Active07/01/201706/30/20181908R75880 Zaw Yuzana Khin Active07/01/201706/30/2018 HonorHealth Scottsdale Osborn1908R75015 Choo Jean So Young Active07/01/201706/30/20181908R75560 DeGrio Arie Jase Active07/01/201706/30/20181908R75019 Garcia Ann Catherine Active07/01/201706/30/20181908R76084 Holman Bradley Active07/01/201706/30/20181908R74444 Kruger Tricia Marie Active07/01/201706/30/20181908R75020La Rosa William Robert Active07/01/201706/30/20181908R75016 Merz Kara CombsActive07/01/201706/30/20181908R7502 1 Powell Matthew Reed Active07/01/201706/30/20181908R76113 Wagner Glenn Travis Active07/01/201706/30/20181908R76114 Webb Jeremy Daniel Active07/01/201706/30/20181908R76115 Wypiszynski Sarah D Active07/01/201706/30/2018 HonorHealth Scottsdale Thompson Peak Medical Center1908R75481 Chaudhari Harshad Kumar Active07/01/201706/30/20181908R76165 Davis Daniel Adam Active07/01/201706/30/20181908R76172 Hundley Evan Lynn Active07/01/201706/30/20181908R75099 Lawson Benjamin Ondreyco Active07/01/201706/30/2018 Page Number 5 of 47 Arizona Medical BoardFacilityLictypeLicense Num LicenseeStatusStart DateEnd DateHonorHealth Scottsdale Thompson Peak Medical

9 Center1908R75480 MacDonald Alexis Upton Active07/01/201706/30/20181908R75482 Petersen Jameson Ross Active07/01/201706/30/20181908R75478 Varadarajan Rangashree Active07/01/201706/30/2018 HonorHealth Scottsdale Thompson Peak Medical Center1908R75479 Bikowski Brandon Michael Active07/01/201706/30/2018 Maricopa Medical Center1908R75171 Ahmad Mamuna Active06/23/201706/22/20181908R75619Al Charakh Mohammed B. Active06/23/201706/22/20181908R75172Al Marzooq Ali A. Active06/23/201706/22/20181908R76243Al-a bbadi Tabarik Khalil Active06/23/201706/22/20181908R75615 Albadwi Gheyath G Active06/23/201706/22/20181908R76137 Aldridge Morgan Leigh Active06/15/201706/14/20181908R75173 Alnaser Ammar Active06/23/201706/22/20181908R76133 Alshati Ali Salim Abood Active06/15/201706/14/20181908R73870 Alt Rachel Louise Active06/23/201706/22/20181908R75174 Apstein Ted Elliott Active06/23/201706/22/20181908R76583 Arendovich Nikolai Active04/03/201804/16/20181908R76134 Armstrong Tamara Marie Active06/15/201706/14/20181908R76241 Baer Shoshauna Grace Active06/23/201706/22/20181908R75175 Bajwa Inderjot K.

10 Active06/23/201706/22/20181908R76301 Barlingay Gauri Stephanie Chelsea Sha'llah Mark Gregory Yanez Active06/23/201706/22/20181908R74717 Callow Samantha Myers Active07/01/201706/30/20181908R76132 Carman Aubri Sue Active06/15/201706/14/20181908R76131 Carotenuto Giuseppe Active06/15/201706/14/20181908R75179 Carter Ashley Elizabeth Active06/23/201706/22/20181908R76129 Chalifour Stephanie Anne Arif Riaz Active03/01/201806/29/20181908R76130 Chen Weihua Active06/15/201706/14/20181908R75181 Chundu Navya Active06/23/201706/22/20181908R74738 Cocco Daniela Active06/23/201706/22/2018 Page Number 6 of 47 Arizona Medical BoardFacilityLictypeLicense Num LicenseeStatusStart DateEnd DateMaricopa Medical Center1908R74541 Colglazier Roy John Active07/01/201706/30/20181908R74078 Collins Michael Robert Active07/01/201706/30/20181908R75623 Considine Perrin Thalia Ashley Kristen Robert Thomas JrActive07/01/201706/30/20181908R75182 Dahl Aaron J.