Arizona Medical Board Resident List Revised: 05/07/2021
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Arizona Medical Board Resident List Revised: 05/07/2021 Facility Lictype License Num Licensee Status Start Date End Date 1908 R78425 Gold Jillian Active 05/24/2021 06/11/2021 1908 R78489 Lindstrom Sorren Deanna Active 05/26/2021 06/25/2021 1908 R78496 Oni-Orisan Adeola Oladayo Active 05/03/2021 05/14/2021 Abrazo Health Network Arrowhead Campus 1908 R77916 Arias Sandra Isabel Active 07/01/2021 06/30/2022 1908 R77896 Arora Aniket Active 06/29/2021 06/28/2022 1908 R77474 Ayeni Aduragbemi Julianah Active 07/01/2021 06/30/2022 1908 R77473 Bodagh Fady Active 07/01/2021 06/30/2022 1908 R77440 Brown O'Shaine G Active 07/01/2021 06/30/2022 1908 R77891 Cherian Geo Aji Active 06/29/2021 06/28/2022 1908 R77892 Dixon Harmony B Active 06/29/2021 06/28/2022 1908 R77436 Fisher Jordan A Active 07/01/2021 06/30/2022 1908 R77434 Gomez Nina Active 07/01/2021 06/30/2022 1908 R77917 Jabassini Mostafa Tawfiq Active 07/01/2021 06/30/2022 1908 R77433 Khan Neha Active 07/01/2021 06/30/2022 1908 R77894 Kirk Mark Steven Jr Active 06/29/2021 06/28/2022 1908 R77893 Malik Leena F Active 06/29/2021 06/28/2022 1908 R77895 Menon Tushar Active 06/29/2021 06/28/2022 1908 R78770 Musallam Serene Active 06/28/2021 06/27/2022 1908 R77587 Navarro Castaneda Alejandr... Active 07/01/2021 06/30/2022 1908 R77439 Rahman Haitham Active 07/01/2021 06/30/2022 1908 R77438 Rodriguez Nylund Jorge Eva... Active 07/01/2021 06/30/2022 1908 R77435 Shah Raj B Active 07/01/2021 06/30/2022 1908 R77437 Singh Monider M Active 07/01/2021 06/30/2022 1908 R78771 Singh Sukdev Active 06/28/2021 06/27/2022 1908 R77432 Stewart Daniel J Active 07/01/2021 06/30/2022 Abrazo Health Network Central Campus 1908 R76794 Alves Clark Active 07/01/2020 06/30/2021 1908 R76795 Anderson Jason Active 07/01/2020 06/30/2021 1908 R76796 Ballanca Zerahlynn Active 07/01/2020 06/30/2021 1908 R77492 Brown-gonzalez Natali Active 07/01/2021 06/30/2022 1908 R78259 Desmarais Ashley Marie Active 07/01/2021 06/30/2022 1908 R76797 Giaquinto Shea Active 07/01/2020 06/30/2021 1908 R77486 Ikegbunam Obianaju Active 07/01/2021 06/30/2022 1908 R78260 Jimenez Linda Emperatriz Active 07/01/2021 06/30/2022 Page Number 1 of 54 Arizona Medical Board Resident List Revised: 05/07/2021 Facility Lictype License Num Licensee Status Start Date End Date Abrazo Health Network Central Campus 1908 R76798 Parmar Henna Active 07/01/2020 06/30/2021 1908 R78261 Peer Ann Therese Active 07/01/2021 06/30/2022 1908 R77491 Rodriguez Perez Veronica Active 07/01/2021 06/30/2022 1908 R76799 West Joshua Active 07/01/2020 06/30/2021 1908 R77493 Zablocki Christopher Active 07/01/2021 06/30/2022 Abrazo Health Network West Campus 1908 R78509 Ballard Matthew Smith Active 06/28/2021 06/27/2022 1908 R77885 Bowman Ty A. Active 07/01/2021 06/30/2022 1908 R78497 Casillas Brian Active 07/01/2021 06/30/2022 1908 R78510 Connor Denton Evald Active 06/28/2021 06/27/2022 1908 R78511 Drake Taylor Michael Active 06/28/2021 06/27/2022 1908 R78495 Francis Eileen Active 07/01/2021 06/30/2022 1908 R78335 Haque Tasmea K Active 06/29/2021 06/28/2022 1908 R78494 Joachim Elizabeth Active 07/01/2021 06/30/2022 1908 R77887 Kamer Matthew Active 07/01/2021 06/30/2022 1908 R78515 Koenig Gavin Active 07/01/2021 06/30/2022 1908 R77888 Kristensen Amy Active 07/01/2021 06/30/2022 1908 R77889 Kunas Grace Active 07/01/2021 06/30/2022 1908 R78512 Motz Alexis Rose Active 06/28/2021 06/27/2022 1908 R78336 Nguyen Uyen-nha A Active 06/29/2021 06/28/2022 1908 R78338 O'connor Colin P Active 06/29/2020 06/28/2021 1908 R78513 Patel Anjana Active 06/28/2021 06/27/2022 1908 R78334 Santiago Sueheidi Active 06/29/2020 06/28/2021 1908 R78517 Young Hayley Active 07/01/2021 06/30/2022 1908 R78516 Young Rebecca Active 07/01/2021 06/30/2022 Barrow Neurological Institute at ST. Joe's Hospital and 1908 R76876 Abbatematteo Joseph Active 07/01/2020 06/30/2021 Me... 1908 R75749 Al Hasan Yazan Mahmoud Active 07/01/2021 06/30/2022 1908 R78308 Anderson Elizabeth J Active 07/01/2021 06/30/2022 1908 R76962 Ashary Zain Abbas Active 07/01/2021 06/30/2022 1908 R75750 Balbuena-Root Melissa Rene... Active 07/01/2020 06/30/2021 1908 R74997 Baranoski Jacob Francis Active 07/01/2020 06/30/2021 1908 R74931 Barbu Shadi Vida Active 07/01/2020 06/30/2021 1908 R76195 Benet Cabero Arnau Active 07/01/2020 06/30/2021 1908 R76961 Breaux Kelly Nicole Active 07/01/2021 06/30/2022 Page Number 2 of 54 Arizona Medical Board Resident List Revised: 05/07/2021 Facility Lictype License Num Licensee Status Start Date End Date Barrow Neurological Institute at ST. Joe's Hospital and 1908 R78316 Breitenbucher Ada Active 07/01/2021 06/30/2022 Me... 1908 R75571 Brigeman Scott Tyler Active 07/01/2020 06/30/2021 1908 R75162 Brown Yvette Michelle Active 07/01/2021 06/30/2022 1908 R77449 Bryant Jonathan Scott Active 07/01/2021 06/30/2022 1908 R75567 Catapano Joshua Stephen Active 07/01/2020 06/30/2021 1908 R77854 Chamberlin Barry R Active 07/01/2020 06/30/2021 1908 R74921 Chan Justine Kit Active 07/01/2020 06/30/2021 1908 R75001 Chen Edward Yuder Active 06/29/2020 06/29/2021 1908 R78309 Cho Steve S Active 07/01/2020 06/30/2021 1908 R76345 Choi Kevin Sukjo Active 07/01/2021 06/30/2022 1908 R74881 Cole Tyler Scott Active 07/01/2020 06/30/2021 1908 R76879 Didomenico Joseph Active 07/01/2020 06/30/2021 1908 R78313 Elahi Cyrus Active 07/01/2020 06/30/2021 1908 R76197 Farber Samuel Harrison Active 07/01/2020 06/30/2021 1908 R78311 Fox Brandon M Active 07/01/2020 06/30/2021 1908 R76878 Furey Charuta Active 07/01/2020 06/30/2021 1908 R74648 Godzik Jakub Active 07/01/2020 06/30/2021 1908 R76347 Gonzalez Daniel Israel Active 07/01/2021 06/30/2022 1908 R77204 Gooldy Timothy Caleb Active 07/01/2020 06/30/2021 1908 R76348 Guidos Paul Anthony Active 07/01/2020 06/30/2021 1908 R77450 Hansra Harjot Kaur Active 07/01/2021 06/30/2022 1908 R77443 Hartke Joelle Nicole Active 07/01/2020 06/30/2021 1908 R75570 Hendricks Benjamin Kevin Active 07/01/2020 06/30/2021 1908 R75752 Hoskin Justin Lynn Active 07/01/2020 06/30/2021 1908 R76349 Houston Drew Michael Active 07/01/2020 06/30/2021 1908 R78319 Johnson Dejarra Active 07/01/2021 06/30/2022 1908 R75025 Jugler Tanner Kris Active 07/01/2020 06/30/2021 1908 R77855 King Brent James Active 07/01/2020 06/30/2021 1908 R75406 Labib Mohamed Ahmed Maher Active 07/01/2020 06/30/2021 1908 R77852 Logsdon Alyssa B Active 07/01/2020 06/30/2021 1908 R78317 Martin Allison Active 07/01/2021 06/30/2022 1908 R75569 Morgan Clinton David Active 07/01/2020 06/30/2021 1908 R76960 Mubarak Huiam Magzoub Active 07/01/2021 06/30/2022 Page Number 3 of 54 Arizona Medical Board Resident List Revised: 05/07/2021 Facility Lictype License Num Licensee Status Start Date End Date Barrow Neurological Institute at ST. Joe's Hospital and 1908 R75109 Mushtaq Raza Active 07/01/2020 06/30/2021 Me... 1908 R76350 Nicholson Alexandra Helene... Active 07/01/2021 06/30/2022 1908 R77445 Pacult Mark Alexander Active 07/01/2020 06/30/2021 1908 R76877 Paisan Gabriella Active 07/01/2020 06/30/2021 1908 R76351 Passeri Michlene Active 07/01/2020 06/30/2021 1908 R77451 Patel Jay Narendra Active 07/01/2021 06/30/2022 1908 R78321 Pauta Martinez Juan Pablo Active 07/01/2020 06/30/2021 1908 R74879 Przybylowski Colin John Active 06/08/2020 06/07/2021 1908 R76959 Ranade Tejas Sanjay Active 07/01/2021 06/30/2022 1908 R75753 Root Shane Marcus Active 07/01/2020 06/30/2021 1908 R77446 Rudy Robert Franklin Adler... Active 07/01/2020 06/30/2021 1908 R78320 Rutledge William Caleb Active 07/01/2020 06/30/2021 1908 R77853 Sale Max Carver Active 07/01/2020 06/30/2021 1908 R74880 Sarris Christina Elizabeth... Active 07/01/2020 06/30/2021 1908 R76958 Sharf Valerie L Active 07/01/2021 06/30/2022 1908 R76957 Singer Madeline Louise Active 07/01/2021 06/30/2022 1908 R76352 Tadipatri Ramya Active 07/01/2021 06/30/2022 1908 R76353 Tarzi Fawaz P Active 07/01/2020 06/30/2021 1908 R78315 Venkatesh Anita Active 07/01/2021 06/30/2022 1908 R74649 Walker Corey Tyler Active 07/01/2020 06/30/2021 1908 R78312 White Michael D Active 07/01/2020 06/30/2021 1908 R74646 Whiting Alexander Charles Active 07/01/2020 06/30/2021 1908 R77452 Wiggins Judea Paulmarie Active 07/01/2021 06/30/2022 1908 R77447 Zavala Baltazar Antonio Active 07/01/2020 06/30/2021 1908 R76198 Zhou James Jun Active 07/01/2020 06/30/2021 College of Medicine, Mayo Clinic 1908 R78486 Abdalla Abdelmohaymin Abda.