September 2001 - the Ohio State Dental Board

FORMAL ACTION REPORTPlease find below a summary of actions taken or initiated by the Ohio StateDental Board in September 2001.1. CITATIONS/PROPOSED DENIALS:KLONOWSKI, MAXINE V. (31001684) – ClevelandBased on the dental hygienist’s alleged failure to comply withthe continuing education requirements for renewal. Notice ofOpportunity for Hearing and Automatic Suspension mailedSeptember 14, 2001.PUSHKIN, YURI Y. (30020369) – WestervilleBased on the doctor’s alleged misrepresentation, falseadvertising, and alleged conviction of a felony. Notice ofOpportunity for Hearing mailed September 14, 2001.2. CONSENT AGREEMENTS:BURLESON, ROGER D. (30019070) – WheelersburgDoctor’s license shall be suspended for thirty (30) days, effectiveDecember 1, 2001 through December 31, 2001. Doctor shallobtain and submit documentation of twenty (20) hours ofcontinuing education in Dental Ethics and Treatment Planningand three (3) hours in office management/billing practiceswithin three (3) months of the effective date. Doctor shall takeand pass the jurisprudence exam within one (1) month of theeffective date. Once reinstated, doctor’s license is subject tofollowing probationary terms for one (1) year: doctor shallmaintain all daily patient schedules at this office for review bythe Board, doctor shall provide a minimum of one hundred andtwenty (120) hours of pro bono dental services to underservedpopulations to be completed within one (1) year of the effectivedate and shall be pre-approved by the Board Secretary and

Formal Action ReportSeptember 2001Page { PAGE }doctor shall fully cooperate in Board inspections and evaluationsof his dental office.Agreement effective September 12, 2001.GABRIEL, THOMAS M. (30014598) – YoungstownDoctor’s license shall be subject to probationary conditions forone (1) year: doctor shall fully cooperate with Board’s inspectionand evaluations, doctor shall submit on a quarterly basisdocumentation that the heat sterilizing devices are being testedfor proper function on a weekly basis, doctor shall complete andsubmit documentation within three (3) months that he hascompleted seven (7) hours of continuing education in infectioncontrol pre-approved by the Board Secretary, doctor shall takeand pass the jurisprudence exam within thirty (30) days of theeffective date of this consent agreement.Agreement effective September 12, 2001.WAGMAN, HARRY (30010142) – YoungstownDoctor’s license shall be subject to probationary conditions forone (1) year: doctor shall fully cooperate with Board’s inspectionand evaluations, doctor shall submit on a quarterly basisdocumentation that the heat sterilizing devices are being testedfor proper function on a weekly basis, doctor shall complete andsubmit documentation within three (3) months that he hascompleted seven (7) hours of continuing education in infectioncontrol pre-approved by the Board Secretary, doctor shall takeand pass the jurisprudence exam within sixty (60) days of theeffective date of this consent agreement.Agreement effective September 12, 2001.3. REINSTATEMENTS:QUILLEN, ADAM W. (30017002) – Columbus

Formal Action ReportSeptember 2001Page { PAGE }Request to suspend last three (3) months of twelve (12) monthsuspension and for reinstatement granted by the Board, subjectto probationary conditions established by August 1998Adjudication Order.Reinstatement effective September 12, 2001.4. VOLUNTARY RETIREMENT(S):STRICKER, DANIEL R. (30011918) – NewarkDoctor hereby voluntarily, knowingly and intelligently retireshis license to practice dentistry in Ohio. This VoluntaryRetirement shall be effective October 1, 2001.