GCMB Approved Emergency Practice Permit/ Temp License 2020

EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

2 4/1/2020 6/17/2020 Brian David Quint MD 586 Bothwell Drive Richmond Hill GA 31324

3 3/19/2020 6/17/2020 Mark E Franke MD 13422 Black Gum Ct Chantilly VA 20151

4 3/19/2020 6/17/2020 Ashley Noelle Davis MD 293 Deering Road NW Atlanta GA 30309

5 3/20/2020 6/20/2020 Tonja L. Gadsden MD 10817 Legend Manor Lane Glenn Dale MD 20769

6 3/20/2020 6/20/2020 Erin Kim APRN 155 South Court Avenue Orlando FL 32801

7 3/20/2020 6/20/2020 Kyle Ward APRN 7800 Freestyle Lane Winter Garden FL 34787

8 3/23/2020 6/20/2020 Mary E. Carrigan APRN 701 15th Ave S. Jax Beach FL 32250

9 3/23/2020 6/20/2020 Christine Thorogood MD 916 E. Pleasant Pl. St. Johns FL 32259

10 3/23/2020 6/20/2020 Courtney Allison Bryant Whatley RCP 98 N. Charity Lane Warner Robins GA 31088

11 3/23/2020 6/20/2020 Julia Tuyet Vu MD 105 Longwood Drive Jonesboro GA 30236

12 3/20/2020 6/20/2020 Susamma George Nathew MD 3525 Sugarloaf Parkway Lawrenceville GA 30044

13 3/23/2020 6/20/2020 Magdy Nassif Falstiny MD 1257 SW 87th PL Ocala FL 34476

14 3/23/2020 6/20/2020 Kirby Douglas Slifer DO 2554 Walker Drive Valparaiso IN 46385

15 3/23/2020 6/23/2020 Roy Niels Skousen DO 2112 Cooperfield Stillwater OK 74074

16 3/23/2020 6/23/2020 John Silver, MD, FCCP MD 810 East Pine Street Stayton OR 97383

17 3/23/2020 6/23/2020 Tiffany Best MD 3300 N. 7th Avenue Phoenix AZ 85013

07-Apr-20 Page 1 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

18 3/23/2020 6/23/2020 Ravikumar Patel DO 104 Chamblee Blvd. Greenville SC 29615

19 3/23/2020 6/23/2020 LaTania Michelle Akers-White, MD MD 512 Besler Lane Richmond VA 23223

20 3/23/2020 6/23/2020 Asha Zakiya Robinson-Parks, MD MD 5137 Sorrento Blvd. W. St. Cloud FL 344771

21 3/23/2020 6/23/2020 Heidi Ann Morris, DO DO 5317 Sanctuary Lane Sheffield village OH 44054

22 3/23/2020 6/23/2020 Peter John Vasquez MD 18427 N. Madison Road Maricopa AZ 85139

23 3/23/2020 6/23/2020 Nathaniel Morin DO 785 32nd Street Boulder CO 80303

24 3/24/2020 6/23/2020 Nicola Mario Zetola MD 3610 Dillon Street Baltimore MD 21224

25 3/24/2020 6/23/2020 Laura Gunder McClary PA 4245 Anderson Circle Evans GA 30809

26 3/24/2020 6/24/2020 Robert Harrell Martin, Jr. MD 1464 South 16th Section Road Monticello AR 71655

27 3/24/2020 6/23/2020 Tuesday Cunningham APRN 10733 Cambbage Tree Loop Orlando FL 32825

28 3/24/2020 6/23/2020 Cam Wagner APRN 401 E. Fairbanks Avenue Winter Park FL 32789

29 3/24/2020 6/23/2020 Eric Palmer APRN 6405 Diane Ct. St. Cloud FL 34771

30 3/24/2020 6/23/2020 Deborah Messier APRN 6362 Sedona Leaf Court Windermere FL 34786

31 3/24/2020 6/23/2020 Sharron McDonald APRN 8408 Diamond Cove Cr. Orlando FL 32838

32 3/24/2020 6/23/2020 Paula Vasquez APRN 1024 Girard Drive Orlando FL 32824

33 3/24/2020 6/23/2020 Heather Elizabeth Henry MD 905 20th Avenue S Nashville TN 37203

34 3/24/2020 6/23/2020 Lynne M. Evoy APRN 14975 Fern Hammock Drive NorthJacksonville FL 32258

35 3/24/2020 6/24/2020 Pamela J. Parsons MD Premier Psychiatric Services, LLCBaton Rouge LA 70816

36 3/26/2020 6/26/2020 Annette Wilson PA 3034 Fermanagh Dr. Tallahassee FL 32309

07-Apr-20 Page 2 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

37 3/26/2020 6/26/2020 Meeredith Ann Stasi PA 7871 Kiverton Place Atlanta GA 30350-588

38 3/26/2020 6/25/2020 Keyanna Monique Williams PA 3505 Cobblestone Blvd. Fayetteville GA 30215

39 3/26/2020 6/25/2020 Heather Ann Lewis Prusik PA 2638 Rangewood Drive Atlanta GA 30345

40 3/26/2020 6/25/2020 Brian Michael Free RCP 75 Rosewood Lane Young Harris GA 30582

41 3/26/2020 6/26/2020 Mark Ivo Kaminski MD 345 E 54th Street New York NY 10022

42 3/26/2020 6/25/2020 John R. Langefeld MD 2246 Vinings CV SE Smyrna GA 30080

43 3/26/2020 6/25/2020 Nicholas Wisnoski MD 154 E 29th Street New York NY 10016

44 3/26/2020 6/25/2020 Amy M. Korn-Reavis RCP 9573 Turkey Oak Bend Orlando FL 32817

45 3/26/2020 6/25/2020 Miri W. Rosen MD 1751 Second Avenue New York NY 10128

46 3/26/2020 6/26/2020 Jonathan Ohenhen MD 921 W. 11th Street Sulphur OK 73086

47 3/26/2020 6/25/2020 Soujanya Pulluru MD 3908 Littlestone Circle Naperville IL 60564

48 3/26/2020 6/26/2020 Tiffani L. Bell MD 6182 Barrington Oaks Dr. Clemmons NC 27012

49 3/26/2020 6/25/2020 Janet Marie Warrington DO 5533 Superior Dr. Lakeland FL 33805

50 3/26/2020 6/26/2020 Kairul Steven Lehardi APRN 10426 S 952 PR SE Kennewick WA 99338

51 3/26/2020 6/26/2020 Steven Arthur Rabin MD 10061 Riverside Dr. Toluca Lake CA 91602

52 3/26/2020 6/26/2020 Tiandra LaShay Quiller RCP 26 Cross Pointe Greenville SC 29607

53 3/30/2020 6/27/2020 Marjorie Lantum MD 333 Cedarcreek Drive Nashville TN 37211

54 3/30/2020 6/27/2020 Heidi Hansen Ashbaugh MD 841 Prudential Drive Jacksonville FL 32207

55 3/30/2020 6/27/2020 Dustin Huntington Brimblecom MD 841 Prudential Drive Jaconsonville FL 32207

07-Apr-20 Page 3 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

56 3/30/2020 6/27/2020 Karah Lynn Brown PA 11395 Old Post Road Hortense GA 31543

57 3/30/2020 6/27/2020 Dantae L. Bowie DO 14 Meadow Valley Court Midland GA 31820

58 3/30/2020 6/27/2020 Marcelo Carlos Darabos DO 841 Prudential Drive Jacksonville FL 32207

59 3/30/2020 6/27/2020 Jasmine Renay Dillard APRN 1401 Centerville Road Tallahassee FL 32308

60 3/30/2020 6/27/2020 David Jerry Dixon DO 1401 Centerville Road Tallahassee FL 32308

61 3/30/2020 6/27/2020 Alexander Dumas Jesse Brickler, III MD 1401 Centerville Road Tallahassee FL 32308

62 3/30/2020 6/27/2020 Erin Michaele Ferguson PA 7304 Gracemont Lane Brunswick GA 31525

63 3/30/2020 6/27/2020 Darrell Wayne Fixler Jr. RCP 178 Somersby Blvd. Pooler GA 31322

64 3/30/2020 6/27/2020 Andrea King Friall MD 1401 Centerville Road Tallahassee FL 32308

65 3/28/2020 6/27/2020 Christopher Joseph Gasho MD 52 Ivy Lane Santa Rosa Beach FL 32459

66 3/30/2020 6/27/2020 Joseph P. Grajo DO 461 Ron Horse Lane Walnut Creek CA 94597

67 3/30/2020 6/27/2020 Candice Priscilla Gregg APRN 1401 Centerville Road Tallahassee FL 32308

68 3/30/2020 6/27/2020 Laura J. Grippa MD 841 Prudential Drive Jacksonville FL 32207

69 3/30/2020 6/27/2020 Francisco Javier Gutierrez DO 841 Prudential Drive Suite 1400 FL 32207

70 3/30/2020 6/27/2020 Amy Marlo Haddock MD 1401 Centerville Road Tallahassee FL 32308

71 3/30/2020 6/27/2020 Stella Marie Hayes MD 841 Prudential Drive, Jacksonville FL 32201

72 3/30/2020 6/27/2020 Smruti J. Kinariwala MD 95002 Buckeye Court Fernandine Beach FL 65267

73 3/30/2020 6/27/2020 Jeffrey Ling Kang MD 147 Royal Palm Drive Fort Lauderdale FL 33301

74 3/30/2020 6/27/2020 Sajid Khan MD 1040 SW 2nd Ave Ocala FL 34471

07-Apr-20 Page 4 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

75 3/30/2020 6/27/2020 Joseph Mark King MD 841 Prudential Drive Jacksonville FL 32207

76 3/30/2020 6/27/2020 Kendra Wooley Marcinowski APRN 1401 Centerville Road Tallahassee FL 32308

77 3/30/2020 6/27/2020 Kenneth John McAlpine MD 1401 Centerville Road Tallahassee FL 32308

78 3/30/2020 6/27/2020 Sean F. McGrath MD 841 Prudential Drive Jacksonville FL 32207

79 3/30/2020 6/27/2020 Vikki Margaret McKinnie MD 1401 Centerville Road Tallahassee FL 32308

80 3/30/2020 6/27/2020 Rajasree Nambron MD 157 Birch Creek Drive Birmingham AL 35242

81 3/30/2020 6/27/2020 Lemuel Pierre PA 10842 Blue Palm Street Plantation FL 33324

82 3/30/2020 6/27/2020 Steven Arthur Rabin MD 10061 Riverside Drive Toluca Lake CA 91602

83 3/30/2020 6/27/2020 Gurijala Ramesh Ramayya MD 215 Autumn Trace Court Macon GA 31210

84 3/30/2020 6/27/2020 Kathleen Elizabeth Sharp MD 2943 Bandera Grand Prairie TX 75054

85 3/30/2020 6/27/2020 Anne-Marie Lewis Singleton APRN 1401 Centerville Road Tallahassee FL 32308

86 3/30/2020 6/27/2020 Kelley Lynn Stem PA 1401 Centerville Road Tallahassee FL 32308

87 3/30/2020 6/27/2020 Christopher Charles Sundstrom MD 1401 Centerville Road Tallahassee FL 32308

88 3/30/2020 6/27/2020 Briana Nicole Thompson MD 1401 Centerville Road Tallahassee FL 32308

89 3/30/2020 6/27/2020 Erin Roberts Thames APRN 1401 Centerville Road Tallahassee FL 32308

90 3/30/2020 6/27/2020 Courtney Blair Fahnhorst Vidrine MD 841 Prudential Drive Jacksonville FL 32207

91 3/30/2020 6/27/2020 Frank J. Welch MD 117 David Road Bala Cynwyd PA 19004

92 3/30/2020 6/27/2020 Elisa Alter Zenni MD 109 Lantern Wick Place Ponte Vedra Beach FL 32082

93 3/30/2020 6/27/2020 Asha Davis MD 888 Biscayne Blvd Miami FL 33132

07-Apr-20 Page 5 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

94 3/30/2020 6/27/2020 Moises Roberto Carpio MD 8555 Station Village Ln San Diego CA 92108

95 3/30/2020 6/27/2020 Laura Michele Crawford RCP 159 Cavan Way Mableton GA 30126

96 3/31/2020 6/30/2020 Mark Ivo Kaminski MD 345 E 54th Street New York NY 10022

97 3/31/2020 6/30/2020 Jesse Concepcion Salas RCP 2587 Dunmoore Drive Snellville GA 30078

98 3/31/2020 6/30/2021 Richard Michael Weathersby RCP 1101 Hardigree Bell Road Bishop GA 30621

99 3/31/2020 6/30/2020 Mary Jo Gochett RCP 2950 Ivey Ridge Lane Roswell GA 30076

100 3/31/2020 6/30/2020 William Michael Wrigley APRN 3949 Old Atlanta Station Ct. Atlanta GA 30339

101 3/31/2020 6/30/2020 David Shields Lesser MD 841 Prudential Drive Jacksonville FL 32207

102 3/31/2020 6/30/2020 Paul Aron Diaz-Granados MD 841 Prudential Drive Jacksonville FL 32207

103 3/31/2020 6/30/2020 Gretta Langley APRN 35153 Quail Road Callahan FL 32011

105 4/1/2020 6/30/2020 Rawan Osama Kablawi MD 841 Prudential Drive Jacksonville FL 32207

106 4/1/2020 6/30/2020 Andrea Marie Fritschle MD 4929 Skyway Drive Jacksonville FL 32246

107 4/1/2020 6/30/2020 Angela Antonacci-Gimbel MD 55 Mahi Drive Ponte Vedra FL 32081

108 4/1/2020 6/30/2020 Christopher Jolley MD 4310 NE 255 Dr. Melrose FL 32666

109 4/1/2020 6/30/2020 Samuel Quaynor MD 8677 Wheatfield Way Ellicott City MD 21043

110 4/1/2020 6/30/2020 Charles Alan McCaslin MD 807 Children's Way Jacksonville FL 32207

111 4/1/2020 6/30/2020 Christina Stockwell Wieczorek MD 841 Prudential Drive Jacksonville FL 32207

112 4/1/2020 6/30/2020 Jeffrey Stephen Smowton MD 841 Prudential Drive Jacksonville FL 32207

113 4/1/2020 6/30/2020 Ryan Budwany MD 2000 Whitetail Ct. Morgantown WV 26508

07-Apr-20 Page 6 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

114 4/1/2020 6/30/2020 Mary Carolyn Watson MD 3361 Shadowmoss Drive Tallahassee FL 32308

115 4/1/2020 6/30/2020 Christina Gindele Caro MD 841 Prudential Drive Jacksonville FL 32207

116 4/1/2020 6/30/2020 Gretta Langley APRN 35153 Quail Road Callahan FL 32011

117 4/1/2020 6/30/2020 Courtney Lynn Taylor RCP 929 Pallet Avenue Harvey LA 70058

118 4/1/2020 6/30/2020 Sarah Isabel Fernandez MD 1431 Riverplace Blvd Jacksonville FL 32207

119 4/2/2020 6/27/2020 William V. Bobo MD Mayo Clinic Jacksonville FL 32224

120 4/2/2020 6/27/2020 Bryce Rushton Tiller MD 841 Prudential Drive Jacksonville FL 32207

121 4/2/2020 6/27/2020 Samantha Marie Maplethorpe MD 701 5th Ave Seattle WA 98104

122 4/2/2020 6/27/2020 Risheet Rajendra Patel MD 701 5th Avenue Seattle WA 98104

123 4/1/2020 6/27/2020 Kelly James Tenbrink MD 701 5th Avenue Seattle WA 98104

124 4/2/2020 6/27/2020 Mubina Nasri MD 701 5th Ave Seattle WA 98104

125 4/2/2020 6/27/2020 Jill Anne Griffin MD 701 5th Ave Seattle WA 98104

126 4/2/2020 9/9/1984 Kylene Nicole Haskins DO 701 5th Ave Seattle WA 98104

127 4/2/2020 7/1/2020 Rebecca Jean Payne APRN 281 N. Lyerly Street Chattanooga TN 37404

128 4/1/2002 7/2/2020 Shyam Yallapragada MD 68 Ocean Point Drive Isle of Palms SC 29451

129 4/2/2020 7/2/2020 Mary Carolyn Watson MD 3361 Shadowmoss Drive Tallahassee FL 32308

131 4/3/2020 6/25/2020 Elizabeth Marini Simpson DO 1035 Executive Drive Hixson TN 37343

132 4/2/2020 6/30/2020 Issa Yusuf MD 12150 Annapolis Road Glenn Dale MD 20769

133 4/3/2020 7/1/2020 Antonio Rodriguez MD 1801 Wingfield Drive Longwood FL 32779

07-Apr-20 Page 7 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

134 4/3/2020 7/2/2020 Christopher Lesean Ifill MD 9554 Yellow Finch Ct. Brentwood TN 37027

135 4/3/2020 7/2/2020 Marjorie Dolezel Timmer RCP 1729 Coventry Road Decatur GA 30030

136 4/3/2020 7/2/2020 LaTosha Y. Flowers MD P O Box 182363 Arlington TX 76096

137 4/3/2020 7/2/2020 Andrea Marie Fritschie MD 4929 Skyway Drive Jacksonville FL 32246

138 4/3/2020 7/2/2020 Johnny Dias DO 5 Hidden Oak Ter Simpsonville SC 29681

139 4/3/2020 11/4/1955 Gayla Jean Singleton RCP 310 Chandler Court Sugar Hill GA 30518

140 4/3/2020 7/2/2020 Smruti J. Kinariwala MD 95002 Buckeye Court Fernandina Beach FL 32034

141 4/3/2020 7/2/2020 Parks Winfield Pratt MD 4300 West Main Street Dothan AL 36305

142 4/3/2020 7/2/2020 Faye Elaine Rao MD 4300 West Main Street Dothan AL 36305

143 4/3/2020 7/2/2020 Bethany Grace Shovlin APRN 140 Traveler Palm Court Ponte Vedra Beach FL 32082

144 4/3/2020 7/2/2020 Louis Todd House MD 315 S. Bayly Avenue Louisville KY 40206

145 4/3/2020 7/2/2020 Rosa E. Turcios MD 1126 W. State Street Marshfield WI 54449

146 4/3/2020 7/2/2020 Angela Antonacci-Gimbel MD 55 Mahl Drive Ponte Vedra FL 32081

147 4/3/2020 7/2/2020 Tonia Lee Ruddock MD 4300 West Main Street Dothan AL 36305

148 4/3/2020 7/3/2020 Simon Roland Brooks MD 4300 West Main Street Dothan AL 36305

149 4/3/2020 7/2/2020 Robert Benjamin Ash MD 4300 West Main Street Dothan AL 36305

150 4/3/2020 7/3/2020 Magan Bond Parker APRN 4300 West Main Street Dothan AL 36305

151 4/3/2020 7/2/2020 Laura McNeely Tamburin MD 4300 West Main Street Dothan AL 36305

152 4/3/2020 7/2/2020 Kelli Nicole Heer PA 4300 West Main Street Dothan AL 36305

07-Apr-20 Page 8 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

153 4/3/2020 7/2/2020 Craig Dean Omohundro MD 1433 West Main Street Dothan AL 36305

154 4/3/2020 7/2/2020 Brooke Barnes Sellers APRN 4300 West Main Street Dothan AL 36305

155 4/3/2020 7/2/2020 Brittney Hatcher Edge APRN 4300 West Main Street Dothan AL 36305

156 4/3/2020 7/3/2020 Tony Samir Faris DO 1370 Talon Way Melbourne FL 32934

157 4/3/2020 7/2/2020 Juan Carlos Cucalon MD 4219 Anne Ct Miami FL 33133

158 4/3/2020 7/2/2020 Thomas Edward Knuth MD 212 Stephens Road Grosse Pointe Farms MI 48236

159 4/3/2020 7/2/2020 Tiffany Michelle Ingrham MD 100 Shady Run LN Rochester NY 14625

160 4/3/2020 7/2/2020 Michelle Jonelle Urban RCP 7621 Charm CT. Las Vegas NV 89129

161 4/3/2020 7/2/2020 Melanie Denise Jones PA 250 North State Hwy 360 Mansfield TX 76063

162 4/3/2020 7/2/2020 Patricia M. Pavlak RCP 30 Morrison Street NW Marietta GA 30064

163 4/3/2020 7/2/2020 David Alan Wiles MD 281 N Lyerly Street Chattanooga TN 37404

164 4/3/2020 7/2/2020 Daun Johnson Lai MD 2530 Winding View San Antonio TX 78260

165 4/3/2020 7/2/2020 Glenn Harnett MD 4425 Sicard Hollow Road Birmingham AL 35242

166 4/3/2020 7/2/2020 Scott Martin Andes DO 1685 Fenimore Road Hewlett NY 11557

167 4/3/2020 7/2/2020 Brian D Smith MD 101 Via Salamanca San Clemente CA 92672

168 4/3/2020 7/2/2020 Robert Howard Lingerfelt RCP 7843 Lanerose Place San Antonio TX 78251

169 4/3/2020 7/2/2020 D'Mya Genise Clark 270 Honeysuckley Dr. Macon GA 31217

170 4/3/2020 7/2/2020 Paul Anthony Bryant MD 2009 Castleman Drive Nashville TN 37215

171 4/3/2020 7/2/2020 Nicole R Davidson PA 7314 E Madero Ave Mesa AZ 85209

07-Apr-20 Page 9 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

172 4/3/2020 7/2/2020 Jeffrey S Ward RCP 1090 CO RD 864 Wadley AL 36276

173 4/6/2020 7/3/2020 Olajide Ayool MD 5422 Bright Run San Antonio TX 78240

174 4/6/2020 7/3/2020 Rochelle Jettahn Skitt MD 866 Ulster Way Denver CO 80230

175 4/6/2020 7/6/2020 Jamie Ayers APRN 8680 Baymeadows Road East Jacksonville FL 32256

176 4/6/2020 7/6/2020 Angela Antonacci-Gimbel MD 55 Mahi Drive Ponte Vedra FL 32081

177 4/6/2020 7/6/2020 Donald Bennett MD 5000 Cedar Croft Drive Bethesda MD 20814-392

178 4/6/2020 7/6/2020 UWE Blecker MD 1431 Riverplace Boulevard Jacksonville FL 32207

179 4/6/2020 7/6/2020 Michael Joseph Bradburn DO 2168 Ketch Court Fernandina Beach FL 32034

180 4/6/2020 7/6/2020 Scott Mark Bradfield MD 67 Nantucket Island Ct. Ponte Vedra FL 32081

181 4/6/2020 7/6/2020 William S. Campbell., Jr. MD 609 North Bay Drive Lynn Haven FL 32444

182 4/6/2020 7/6/2020 Jill Dorsey MD 807 Children's Way Jacksonville FL 32207

183 4/6/2020 7/6/2020 Kristi Dvorak APRN 101 Greenbriar Estates Drive Jacksonville FL 32259

184 4/6/2020 7/4/2020 Alexander Sinclair Franz MD 1401 Centerville Road Tallahassee FL 32308

185 4/6/2020 7/20/2020 Jacob Marshall Gillikin MD 3926 Danforth Drive W Jacksonville FL 32224

186 4/6/2020 7/6/2020 Margaret Ashley Houston APRN 244 Odomr Mill Blvd. Ponte Vedra Beach FL 32082

187 4/6/2020 7/6/2020 James Edward Jolley, II MD 281 N. Lyerly Street Chattanooga TN 37404

188 4/6/2020 7/6/2020 Harry S. Abram MD 3672 Cathedral Oaks Place N. Jacksonville FL 32217

189 4/6/2020 7/6/2020 Christy Michelle Cockern RCP 3637 Trinity Mills Road Dallas TX 75287

190 4/6/2020 7/6/2020 Darcy Andrew Krueger MD 6236 Socialville Foster Road Mason OH 45040

07-Apr-20 Page 10 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

191 4/6/2020 7/6/2020 Daniel Joseph Lattin MD 712 Montego Road W. Jacksonville FL 32216

192 4/6/2020 7/6/2020 Linda Russell Maywood APRN 6 Cove Road Ponte Vedra Beach FL 32082

193 4/6/2020 7/6/2020 Katherine Eileen McGoogan MD Nemours Children's Specialty CareJacksonville FL 32207

194 4/6/2020 7/6/2020 Norma Faye McKnight APRN 1004 Skipper Road Dothan AL 36301

195 4/6/2020 7/6/2020 Rebecca Jean Payne APRN 281 N Lyerly Street Chattanooga TN 37404

196 4/6/2020 7/6/2020 David A Schaeffer MD Nemours Children's Specialty CareJacksonville FL 32207

197 4/6/2020 7/6/2020 Jessica Leighanne Scott PA 281 N Lyerly Street Chattanooga TN 37404

198 4/6/2020 7/6/2020 Kathy Dunaj Sella MD 4438 Tradewinds Drive Jacksonville Beach FL 32250

199 4/6/2020 7/6/2020 Mark Macgillivray Shoemaker MD 635 Fifth Avenue Albany GA 31701

200 4/6/2020 7/6/2020 Mary Patricia Sullivan DO 17920 Palm Circle Ft. Myers Bch FL 33931

201 4/6/2020 7/6/2020 Kelly Summers APRN 1238 Ingleside Ave Jacksonville FL 32205

202 4/6/2020 7/6/2020 Teresa Cleotilde Stewart MD 226 Osprey Hammock Trail Sanford FL 32771

203 4/6/2020 7/6/2020 Wayne Thomas Stewart MD 226 Osprey Hammock Trail Sanford FL 32771

204 4/6/2020 7/6/2020 Alpha J Watson MD 110 Easy Street Dublin GA 31021

205 4/20/2020 7/6/2020 Arkady Vaknansky MD 1800 S Ocean Dr. Hallandale Beach FL 33009

206 4/6/2020 7/6/2020 Adriana R. Vasquez MD Mayo Clinic Jacksonville FL 32224

207 4/6/2020 7/6/2020 Paul C. Wilson RCP 1817 Andrew Jackson Court Jefferson GA 30549

208 4/6/2020 7/6/2020 Meredith Ann McKean MD 250 25th Ave. N Nashville TN 37203

209 4/7/2020 7/7/2020 Guillermo Vincent Sanchez PA 1301 South Perry St. Montgomery AL 36104

07-Apr-20 Page 11 of 12 EPP ID# Approved Expires O Full_Name Profession Address_line 1 City State Zip Code

210 4/7/2020 7/7/2020 Mark McCommons MD 200 W Maple Street Johnson City TN 37604

07-Apr-20 Page 12 of 12