Indiana Board of Chiropractic Examiners s1

INDIANA STATE BOARD OF DENTISTRY AGENDA Will meet on Friday, February 4, 2011 at 8:30 a.m.

Indiana Professional Licensing Agency Indiana Government Center South 402 West Washington Street, Room W064 Indianapolis, Indiana

I. CALL TO ORDER AND ESTABLISHMENT OF QUORUM 8:30 a.m.

II. ADOPTION OF AGENDA

III. ADOPTION OF THE MINUTES:

A. December 3, 2010 Executive Session B. December 3, 2010

IV. APPEARANCES

A. PROBATIONARY 8:30 a.m.

1. Michael Edward Bajza, D.D.S., License No. 12009652A Administrative Cause No. 2005 DB 0011

2. Raymond Burris, D.D.S., License No. 12006355A Administrative Cause No. 2009 ISDB 0010

3. Courtney Carpenter, L.D.H., License No. 13006865A Administrative Cause No. 2010 ISDB 0012

4. William Paul Cornils, D.D.S., License No. 12007331A Administrative Cause No. 2010 ISDB 0009

5. David S. Kilgore, D.D.S., License No. 12011506A Administrative Cause No. 2010 ISDB 0007

6. Christopher S. Leonard, D.D.S., License No. 12009363A Administrative Cause No. 2005 DB 0002

7. Edward Mamaril, D.D.S., License No. 12008594A Administrative Cause No. 2008 ISDB 0001

8. Carrie Anne Striplin, L.D.H., License No. 13004600A Administrative Cause No. 2010 ISDB 0008

9. Philip Ray Travis, D.M.D., License No. 12011406A Administrative Cause No. 2010 ISDB 0003

B. RENEWAL/REINSTATEMENT

1. Lynn Lavender McNamee 9:15 a.m. License No. 13002795A

1 C. APPLICATION

1. Patrick Murphy, President 9:15 a.m. Mid America Professional Group, P.C.

V. ADMINISTRATIVE HEARINGS

A. Charles J. Durham, D.M.D, License No. 12006254A 10:00 a.m. Administrative Cause No. 2010 ISDB 0018 Re: Emergency Suspension

B. Mathew Negrelli, D.D.S., License No. 12009878A 10:30 a.m. Administrative Cause No. 2009 ISDB 0005 Re: Petition for Reinstatement of Suspended License

C. Robin M. Thoman, D.D.S., License No. 12008941A 11:00 a.m. Administrative Cause No. 2010 ISDB 0016 Re: Complaint

D. Michelle Tissot-Ebeyer, D.D.S., License No. 12010621A 11:30 a.m. Administrative Cause No. 2011 ISDB 0001 Re: Complaint

E. Byron Moore, D.D.S., License No. 12010628A 11:45 a.m. Administrative Cause No. 2010 ISDB 0014 Re: Complaint and Emergency Suspension

VI. DISCUSSION

A. Indiana University School of Dentistry Re: Coronal Polishing and Anticaries Continuing Education Program

B. Indiana University South Bend Re: Local Anesthesia and Pain Control Continuing Education Program

C. Dr. Mike T. Smith, Director The Trinity Free Clinic Re: Approval for Prescriptive Supervision for Dental Hygiene

D. Doug Bush Indiana Dental Association Re: Ethics and Jurisprudence Course

VII. APPLICATION REVIEW

A. Examination 1. Nora Caitlin Bault Keller, L.D.H.

B. Endorsement

C. Anesthesia and Sedation Permits

D. Dental Intern Permit

E. Mobile Dental Facility

F. Instructors License

2 G. Professional Corporations

VIII. PROBATIONARY REPORT

A. Penelope Dunlap, D.D.S.

B. Marci Huth, L.D.H.

C. Trevor Treasure, D.D.S.

IX. CONTINUING EDUCATION

A. Harold C. Avila, DDS, MS

B. Advanced EndoCare

X. REPORTS

XI. OLD/NEW BUSINESS

XII. ASSOCIATION REPORTS

A. Indiana Dental Association

B. Indiana Dental Hygiene Association

C. Indiana Dental Assistants Association

XIII. ADJOURNMENT

Next Scheduled Meeting:

Friday, April 1, 2011 Indiana Government Center South 402 West Washington Street, Room W064 Indianapolis, Indiana