Physician Misconduct and Physician Discipline

Physician Information

Physician Information

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Physician Records

 Physician Last Name:


 Physician First Name:


 Physician Middle Name:

 Address:8998 Nathaniel's Hollow Cincinnati, Ohio 45249
 License Number:136082
 License Type:MD
 Year of Birth:
 Effective Date:12/30/1996
 Action Description for DOH Webpage:License suspension for three years after which probation for two years commencing upon the physician's active practice of medicine in New York State.The period of suspension was lifted December 30, 1999. Later effective April 10, 2018 the physician's New York State medical license was surrendered.
 Misconduct Description for DOH Webpage:The physician admitted guilt to the charge of having practiced the profession fraudulently by having made a fraudulent statement on his New York State license registration application.
  License Restrictions for DOH Webpage:
 Board Order: