MINUTES COLORADO DENTAL BOARD OPEN LICENSING SESSION – PANEL B DECEMBER 8, 2016 – 8:02 P.M. 1560 BROADWAY, SUITE 110D DENVER, CO 80202 I. CALL TO ORDER MEMBERS: Lisa Fox, BSN, DDS, Board Chairperson; Mason Miner, DDS, Panel Chairperson; David Thurgood, DDS, MS, Panel Vice-Chairperson; and Patricia Schonberger, RDH MEMBER PRESENT VIA TELECONFERENCE: Gail Raether, DDS MEMBERS ABSENT: Annette G. Isenbart, RDH and Susan Warren, Public Member LEGAL COUNSEL: C. Brent Kelly, Senior Assistant Attorney General DIVISION STAFF: Maulid Miskell, Program Director; Dennis Rhodes, Expedited Settlement Specialist; Jessica Lehew, Compliance Monitor; Melissa Weiss, Program Manager; and Widney Gay, Program Support Assistant

II. MINUTES A motion was made, seconded and carried to approve the October 27, 2016, Open Session meeting minutes as presented.

III. PERMITS ADMINISTRATIVE LICENSURE CONSENT ITEMS Newly Permitted Administrative Anesthesia – Moderate Sedation and Local Anesthesia A motion, was made, seconded and carried to approve the consent items.

*Moderate Sedation Newly Permitted Approval Date: October 29, 2016 Connor Rivers

MODS.2786123

*Local Anesthesia Newly Permitted Approval Date: September 20, 2016 Chantel Stoddard Approval Date: October 13, 2016 Elizabeth Frauen

LOCAL.1058

LOCAL.1069 1

Miriam Freire Jessica Himalstein Paige Simon

LOCAL.1070 LOCAL.1068 LOCAL.1071

Approval Date: October 18, 2016 Paige Atkinson Serena Fernandez Ernestina Givan Samantha Isler Alonna-Jane Ku Amber Nielsen

LOCAL.1077 LOCAL.1075 LOCAL.1072 LOCAL.1076 LOCAL.1073 LOCAL.1074

Approval Date: October 25, 2016 Kimberly Adams Sheyenne Boorman Ileena Carrasquillo Renee Chacon Stephany Dibble Ashley Still

LOCAL.1082 LOCAL.1078 LOCAL.1081 LOCAL.1080 LOCAL.1079 LOCAL.1083

Approval Date: November 3, 2016 Cassandra Witte

LOCAL.1084

Approval Date: November 9, 2016 Amy Bowers Mary Gardner Katelynn Gebhardt Rocio Mendez-Ponce Osman Nasreldin Monica Sodic Roseanne Young

LOCAL.1088 LOCAL.1086 LOCAL.1090 LOCAL.1089 LOCAL.1087 LOCAL.1085 LOCAL.1091

Approval Date: November 27, 2016 Amanda Sirianni

LOCAL.1092

Approval Date: September 30, 2016 Serena Aragon Kayla Baker Carole Collins Courtney Krei Anai Quezada-Bencomo Brittany Satterwhite Heather Siegfried Allison Spicer Donna Wallin

LOCAL.1093 LOCAL.1099 LOCAL.1097 LOCAL.1094 LOCAL.1101 LOCAL.1100 LOCAL.1095 LOCAL.1098 LOCAL.1096

IV. ANESTHESIA APPLICATIONS REQUIRING BOARD REVIEW 2

MODERATE SEDATION: 1. Zachary Alleman, DDS – MODS New, Opt In – Inspection A motion was made, seconded and carried to grant Dr. Alleman’s Moderate Sedation Permit with a Pediatric Designation. 2. Gregory Bennett, DDS – MODS New, Opt Out – Inspection

A motion was made, seconded and carried to grant Dr. Bennett’s Moderate Sedation Permit without a Pediatric Designation. 3. Tandi Donaldson, DDS – MODS New, Opt In – Application A motion was made, seconded and carried to grant Dr. Donaldson an Inspection Permit. 4. Connor Gina Graziani, DDS – MODS New, Opt In – Inspection

A motion was made, seconded and carried to grant Dr. Graziani a Moderate Sedation Permit with a Pediatric Designation. 5. Alison Grover, DDS – MODS New, Opt In – Inspection A motion was made, seconded and carried to grant Dr. Grover Moderate Sedation Permit with a Pediatric Designation. 6. Geoffrey Haradon, DDS – MODS Renewal, Opt Out – App & Inspection A motion was made, seconded and carried to deny the renewal of Dr. Haradon’s Moderate Sedation Permit.

7. Stacy Jackson, DDS – MODS New, Opt In – Application A motion was made, seconded and carried to grant Dr. Jackson an Inspection Permit. 8. Karl Lackler, DDS – MODS Renewal, Opt Out – App & Inspection A motion was made, seconded and carried to deny the renewal of Dr. Lackler’s Moderate Sedation Permit.

9. Charles Powell, DDS – MODS Renewal, Opt Out – App & Inspection A motion was made, seconded and carried to grant the renewal of Dr. Powell’s Moderate Sedation Permit without a Pediatric Designation. 10. Adam Weaver, DDS – MODS Renewal, Opt Out – App & Inspection

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A motion was made, seconded and carried to grant the renewal of Dr. Weaver’s Moderate Sedation Permit without a Pediatric Designation

11. Joseph Zufall, DDS – MODS Renewal, Opt Out – App & Inspection A motion was made, seconded and carried to grant the renewal of Dr. Zufall’s Moderate Sedation Permit without a Pediatric Designation.

DEEP SEDATION/GENERAL ANESTHESIA: 1. Nathan Baxter, DDS – GEN Renewal, Opt Out – App & Inspection A motion was made, seconded and carried to deny the renewal of Dr. Baxter’s Deep Sedation/General Anesthesia Permit. 2. James Berwick, DDS – GEN Renewal, Opt In – App & Inspection A motion was made, seconded and carried to grant renewal of Dr. Berwick’s Deep Sedation/General Anesthesia Permit with a Pediatric Designation.

3. Eric Blamires, DMD – GEN Renewal, Opt In – App & Inspection A motion was made, seconded and carried to grant the renewal of Dr. Blamires’s Deep Sedation/General Anesthesia Permit with a Pediatric Designation. 4. Daniel Chatterley, DDS – GEN New, Opt Out – Application A motion was made, seconded and carried to conditionally grant Dr. Chatterley’s Deep Sedation/General Anesthesia Permit without a Pediatric Designation.

5. Mariam Hamidi, DMD – GEN Renewal, Opt In – App & Inspection A motion was made, seconded and carried to grant the renewal of Dr. Hamidi’s Deep Sedation/General Anesthesia Permit with a Pediatric Designation.

6. John Hildebrandt, DDS – GEN Renewal, Opt In – App & Inspection A motion was made, seconded and carried to grant the renewal of Dr. Hildebrandt’s Deep Sedation/General Anesthesia Permit with a Pediatric Designation. 7. Brandon Payne, DDS – GEN Renewal, Opt In – App & Inspection A motion was made, seconded and carried to grant the renewal of Dr. Payne’s Deep Sedation/General Anesthesia Permit with a Pediatric Designation.

8. Julia Plevnia, DDS – GEN Renewal, Opt In – App & Inspection

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