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Physician Last Name Physician First Name Physician Middle Name License Number License Type Effective Date Date Updated Year of Birth Clerizier Soshana M. 318149 MD 04/08/2024 04/04/2024 1989 Mittal Niranjan K. 162509 MD 04/08/2024 04/01/2024 1953 Hobbs-Green Roxanne 181769 MD 04/15/2024 04/09/2024 1960 Tatum David Arthur 279951 DO 04/15/2024 04/09/2024 1982 Hartlieb Laura A. 013902 PA 04/15/2024 04/09/2024 1982 Jordan Matthew J. 015551 PA 04/15/2024 04/09/2024 1981 Horton Daniel A. 024076 PA 04/15/2024 04/08/2024 1982 Isaac George B. 204255 MD 04/19/2024 04/12/2024 1960 Venerus Bryan J. 229527 MD 04/23/2024 04/16/2024 1961 Santiago Julian A. 019319 PA 04/24/2024 04/17/2024 1993 Nelson Alan J. 125202 MD 04/24/2024 04/17/2024 1945 Stoll Andrew M. 174508 MD 04/24/2024 04/17/2024 1958 Ross Jonathan M. 127593 MD 04/29/2024 04/22/2024 1945 Ali Syed Masood 162447 MD 04/29/2024 04/22/2024 1940 Baram Vadim 230500 MD 04/29/2024 04/22/2024 1967 Delrosario Gonzalez Nancy 113372 MD 05/03/2024 04/30/2024 1940 Delrosario-Gonzalez Nancy 113372 MD 05/03/2024 04/30/2024 1940 Lape Jeffrey 000489 PA 05/08/2024 05/01/2024 1952 Jones Ryan T. 026201 PA 05/09/2024 05/02/2024 1985 Chisholm David R. 162699 MD 05/17/2024 05/14/2024 1957 [First/Prev] 437,438,439,440,441,442,443,444 [Next/Last]

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