Discrepancy 70410112

Date Reported
2021-09-30 16:14:55.545
 
Discrepancy Status
Completed
Contact Name
Debra Fisher
 

The following report is against a Reappointment Profile for Dawn Behr-Ventura.
It was ordered on 2021-09-13 15:39:18.13 in order o88678097.

Contact Information

Debra Fisher
7609844460
dfisher@theradiologygroup.org

Discrepancy Details

State License(s) 1

Item Correction
Status Active
License Number 067187
Remove Licence No
State Expiration Date 05/31/2022
Issuing State CT
Issue Date 12/31/2020
License Type Unlimited
Profession Type MD
License Additional Notes License not listed on AMA
AMA Comments
The AMA Physician Masterfile has been updated. The data discrepancy that you submitted has been investigated with the primary source. The AMA Physician Profile has been updated to reflect the information as verified by the primary source, which may include different information than what you submitted.

State License(s) 2

Item Correction
Status Active
License Number 322490
Remove Licence No
State Expiration Date 05/31/2022
Issuing State LA
Issue Date 05/04/2020
License Type Unlimited
Profession Type MD
License Additional Notes License not listed on AMA
AMA Comments
The AMA Physician Masterfile has been updated. The data discrepancy that you submitted has been investigated with the primary source. The AMA Physician Profile has been updated to reflect the information as verified by the primary source, which may include different information than what you submitted.

State License(s) 3

Item Correction
Status Active
License Number 53761
Remove Licence No
State Expiration Date 02/28/2022
Issuing State KY
Issue Date 04/17/2020
License Type Unlimited
Profession Type MD
License Additional Notes License not listed on AMA
AMA Comments
The AMA Physician Masterfile has been updated. The data discrepancy that you submitted has been investigated with the primary source. The AMA Physician Profile has been updated to reflect the information as verified by the primary source, which may include different information than what you submitted.

State License(s) 4

Item Correction
Status Active
License Number S8689
Remove Licence No
State Expiration Date 11/30/2021
Issuing State TX
Issue Date 10/30/2020
License Type Unlimited
Profession Type MD
License Additional Notes License not listed on AMA
AMA Comments
The AMA Physician Masterfile has been updated. The data discrepancy that you submitted has been investigated with the primary source. The AMA Physician Profile has been updated to reflect the information as verified by the primary source, which may include different information than what you submitted.

State License(s) 5

Item Correction
Status Active
License Number MD470102
Remove Licence No
State Expiration Date 12/31/2022
Issuing State PA
Issue Date 04/28/2020
License Type Unlimited
Profession Type MD
License Additional Notes License not listed on AMA
AMA Comments
The AMA Physician Masterfile has been updated. The data discrepancy that you submitted has been investigated with the primary source. The AMA Physician Profile has been updated to reflect the information as verified by the primary source, which may include different information than what you submitted.
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