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Physician Last Name Physician First Name Physician Middle Name License Number License Type Effective Date Date Updated Year of Birth Boucree Thaddeus S. 301972 MD 12/12/2023 12/05/2023 1973 Freyer Abhishek 302093 MD 07/22/2021 07/15/2021 1978 Rey Jonathan 302104 MD 08/09/2022 08/02/2022 1965 Zolcik Wojciech 302204 MD 12/05/2023 11/28/2023 1967 Lakowsky Alexander 302379 MD 05/10/2023 05/03/2023 1975 Mamikoglu Bulent 303313 MD 03/17/2023 03/13/2023 1966 Smith Whitaker M. 305209 MD 02/16/2023 02/09/2023 1963 Bentley Keri 305230 MD 05/24/2023 11/06/2023 1972 McFarlane Keri 305230 MD 05/24/2023 11/06/2023 1972 Cheng Zhi A. 305583 MD 04/07/2023 03/31/2023 1989 Riyaz Farhaad R. 306128 MD 08/25/2022 08/22/2022 1987 Lapides David A. 307241 MD 02/15/2023 02/08/2023 1984 Garcia Omar 307694 MD 09/20/2021 09/13/2021 1967 Pavelock Natalie A. 308513 MD 04/28/2022 04/21/2022 1983 Medina Sixto Roberto 308811 MD 08/14/2023 08/07/2023 1983 Medina-Trevino Sixto Roberto 308811 MD 08/14/2023 08/07/2023 1983 McMillion Virgil Waid 310265 DO 04/17/2023 04/10/2023 1974 Gregory Joyce 310488 MD 09/25/2023 09/18/2023 1968 Ross Heather Lynn 311543 MD 09/29/2017 09/22/2017 1981 Kavanagh Patrick D. 314680 MD 12/27/2023 12/20/2023 1970 [First/Prev] 435,436,437,438,439,440,441,442 [Next/Last]

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