9901479
Inactive
Yes
03/19/2015
12/03/2020
See: Actions-Adverse & Administrative Tab
Section 1: Adverse Actions
North Carolina Medical Board Public Actions
This section indicates whether the North Carolina Medical Board has taken adverse public action regarding the
licensee. Click on the link or links below to see an electronic copy of public documents associated with the
licensee.
Certain public documents, such as hearing transcripts, are listed but are not posted on the site. If the record
indicates a transcript is available, it may be obtained by contacting the Board.
NCMB public actions are posted on this site indefinitely.
| Date | Description | Link |
|
08/28/2023
| Entry of Revocation |
View
|
|
06/07/2023
| Notice of Revocation |
View
|
|
10/18/2016
| Relief of Consent Order Obligations |
View
|
|
04/01/2015
| Partial Relief of Consent Order Obligations |
View
|
|
03/19/2015
| Full and Unrestricted License |
View
|
|
10/30/2014
| Temporary Medical License |
View
|
|
07/24/2014
| Amended Consent Order |
View
|
|
02/03/2014
| Consent Order |
View
|
|
04/03/2009
| Denial of Licensure |
View
|
|
07/30/2007
| Consent Order |
View
|
|
01/11/2007
| Voluntary Surrender of License |
View
|
Other Regulatory Board or Agency Public Actions
This section indicates whether a regulatory authority other than NCMB has taken public action against the
licensee. Out-of-state medical board actions are posted on this website indefinitely. Actions by regulatory
agencies such as Medicare, Medicaid, the U.S. Drug Enforcement Administration, the U.S. Food and Drug Administration,
etc., are posted for a period of seven years, from the date of the action.
| Date | Name of Board/Agency | Action Taken | Link |
|
09/26/2023
| Minnesota Board of Medical Practice | Revocation of medical license |
View
|
|
09/27/2019
| Pennsylvania State Board of Medicine | Prior Agreement amended to allow application for reinstatement of medical license |
View
|
|
10/29/2008
| Pennsylvania State Board of Medicine | License voluntarily and permanently surrendered |
View
|
Health Care Institution Suspensions and Revocations
| Date | Health Care Institution | Action Taken |
| None Reported |
Section 2: Administrative Actions
Actions listed in this section are considered non-disciplinary by the Board. In situations where
administrative actions are taken, the licensee may not have met certain statutory requirements or
may have failed to follow correct administrative procedures.
North Carolina Medical Board Reentry Agreement
| Date | Description | Link |
| None Reported |
North Carolina Special Purpose Licensing Agreement
| Date | Description | Link |
| None Reported |