| | Physician Last Name: | Signs |
| | Physician First Name: | Denise |
| | Physician Middle Name: | J. |
| | Address: | Address redacted |
| | License Number: | 166407 |
| | License Type: | MD |
| | Year of Birth: |
1955
|
| | Effective Date: | 08/18/2021 |
| | Action Description for DOH Webpage: | License surrender and the physician is precluded from the practice of medicine in New York State. This modification serves as a substitute for the remaining penalty of the original board order and releases the physician from the registration requirement with the New York State Education Department. |
| | Misconduct Description for DOH Webpage: | This order is a modification of the terms and conditions previously imposed under BPMC Order # 12-69 that went into effect on April 16, 2012 and does not constitute a new disciplinary action. The physician did not contest the charge of committing professional misconduct by having been convicted in the Onslow County District Court, Onslow, North Carolina of impaired driving. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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