State of Minnesota Payments to Practitioners Reporting Form - 2007
Wholesaler/Manufacturer SmithKline Beecham d/b/a GlaxoSmithKline
Name
Wholesaler/Manufacturer 5 Moore Drive, Research Triangle Park, NC 27709
Address
Minnesota License Number 459615-4
Name of Individual Arjun Rajaratnam
Completing Report
Phone number 919-483-9938
Background information and instructions: Minnesota Statutes require wholesale drug distributors and manufacturers to file with the Board of Pharmacy an annual report identifying certain payments made to practitioners. (Practitioners are those licensed health
professsionals who are authorized to prescribe drugs. Pharmacists are not practitioners). The payments that must be reported include: honoraria and payments for expenses of a practitioner who serves as a speaker at a professional or educational conference or
meeting; and compensation for substantial professional or consulting services of a practitioner working on a genuine research project. (See Minnesota Statutes 151.461 and 151.47). The report must identify the specific reason for payments totalling $100 or more.
In the column marked "Specific reason for payment", please list the reason for the payment. (e.g. "honoraria and expenses for speaking", "payment for research consultation", etc.). Do not list general reasons (e.g. "payments for consultation", "payments for
services rendered"). Reports filed under this provision are public data. Reports must be filed in an electronic format, so please fill out this spreadsheet and return it to the Board either attached to an e-mail (Pharmacy.Board@state.mn.us) or copied onto a CD_ROM.
Professional
FIRST NAME OF ADDRESS OF PRACTITIONER PAYMENT INFORMATION
LAST NAME OF PRACTITIONER designation (e.g.
PRACTITIONER
MD), if any Street Address City State Zip Code Value of Payment Specific reason for payment
ADJEI ALEX MD 200 1ST ST SW ROCHESTER MN 55905 $1,574.00 Consultant Fees, Consultant Expenses
BAKER JASON MD 420 DELAWARE ST SE MINNEAPOLIS MN 55455 $1,000.00 Consultant Fees, Consultant Expenses
BENSON KEVIN MD 450 EASTVOLD AVE ORTONVILLE MN 56278 $4,645.50 Consultant Fees, Consultant Expenses
BERGER ALAN MD 420 DELAWARE ST SE MINNEAPOLIS MN 55455 $350.00 Consultant Fees, Consultant Expenses
BERGH BRYAN MD 1801 Nicollet Ave MINNEAPOLIS MN 55403 $100.00 Consultant Fees
BERMAN GARY MD 2805 CAMPUS DR MINNEAPOLIS MN 55441 $167.80 Consultant Expenses
BIJWADIA JAGDEEP MD 401 PHALEN BLVD SAINT PAUL MN 55101 $1,540.00 Consultant Fees, Consultant Expenses
BILLUPS KEVIN L MD 1 VETERANS DR MINNEAPOLIS MN 55417 $6,000.00 Consultant Fees
BLUM PAUL MD 3955 PARKLAWN AVE MINNEAPOLIS MN 55435 $3,317.00 Consultant Fees, Consultant Expenses
BONITATIBUS ANTHONY MD 1020 BANDANA BLVD W SAINT PAUL MN 55108 $7,750.00 Consultant Fees, Consultant Expenses
BOWERS BARBARA MD 6363 FRANCE AVE S MINNEAPOLIS MN 55435 $3,547.40 Consultant Fees, Consultant Expenses
BRANDT TODD MD 8650 HUDSON BLVD N LAKE ELMO MN 55042 $1,000.00 Consultant Fees
BRANSFORD RICHARD MD 825 NICOLLET MALL MINNEAPOLIS MN 55402 $13,550.00 Consultant Fees
CLARKE BART MD 200 1ST ST SW ROCHESTER MN 55905 $3,374.31 Consultant Fees, Consultant Expenses
DAVIDSON LISA MDMS 1230 E MAIN ST MANKATO MN 56001 $3,000.00 Consultant Fees
DOWNS LEVI MD 420 DELAWARE ST SE MINNEAPOLIS MN 55455 $13,301.94 Consultant Fees, Consultant Expenses
DUDEK ARKADIUSZ MD 420 DELAWARE ST SE MINNEAPOLIS MN 55455 $2,764.57 Consultant Fees, Consultant Expenses
DUPREZ DANIEL MD 420 DELAWARE ST SE MINNEAPOLIS MN 55455 $3,032.00 Consultant Fees, Consultant Expenses
ELLINGSON AMY MD 1037 19TH AVE SW WILLMAR MN 56201 $4,581.04 Consultant Fees, Consultant Expenses
ERNST ERIC MD 6405 FRANCE AVE S EDINA MN 55435 $8,270.55 Consultant Fees, Consultant Expenses
FLORENCE ROBERT MD 2555 COUNTY ROAD E E SAINT PAUL MN 55110 $3,324.25 Consultant Fees, Consultant Expenses
FLYNN PATRICK MD 800 E 28TH ST MINNEAPOLIS MN 55407 $5,287.83 Consultant Fees, Consultant Expenses
FONTAINE PATRICIA MD 2020 28TH AVE S MINNEAPOLIS MN 55406 $960.60 Consultant Expenses
FRYE MARK MD 200 1ST ST SW ROCHESTER MN 55905 $1,028.17 Consultant Fees, Consultant Expenses
GARR MICHAEL MD 255 SMITH AVE N SAINT PAUL MN 55102 $1,500.00 Consultant Fees
GEBHART JOHN MD 200 1ST ST SW ROCHESTER MN 55905 $9,621.52 Consultant Fees, Consultant Expenses
GELLER GARY MD 565 SNELLING AVE S SAINT PAUL MN 55116 $11,678.00 Consultant Fees, Consultant Expenses
GOAD ERIC MD 5320 HYLAND GREENS DR MINNEAPOLIS MN 55437 $15,049.72 Consultant Fees, Consultant Expenses
GOLDBERG GARY MD PO BOX 8674 MANKATO MN 56002 $1,593.75 Consultant Fees, Consultant Expenses
GOLDSMITH STEVEN MD 701 PARK AVE MINNEAPOLIS MN 55415 $78,922.68 Consultant Fees, Consultant Expenses
GOODROAD BRIAN NP 1221 W LAKE ST MINNEAPOLIS MN 55408 $12,552.00 Consultant Fees, Consultant Expenses
GROTHE RAYNA MD 200 1ST ST SW ROCHESTER MN 55905 $887.18 Consultant Expenses
GUYER BRENDA MD 3800 PARK NICOLLET BLVD MINNEAPOLIS MN 55416 $2,824.00 Consultant Fees, Consultant Expenses
HACKETT RAYMOND MD 4080 W BROADWAY AVE MINNEAPOLIS MN 55422 $3,335.41 Consultant Fees, Consultant Expenses
HANSEN CHERYL MD 550 S MAPLE ST WACONIA MN 55387 $296.10 Consultant Expenses
HARGROVE JODY MD 7250 FRANCE AVE S MINNEAPOLIS MN 55435 $5,664.90 Consultant Fees, Consultant Expenses
HAYDEN ANN NP 1600 SAINT JOHNS BLVD SAINT PAUL MN 55109 $6,852.54 Consultant Fees, Consultant Expenses
HENRY KEITH MD 915 S 7TH ST MINNEAPOLIS MN 55415 $500.00 Consultant Fees
HENRY WILLIAM MD 555 CEDAR ST SAINT PAUL MN 55101 $12,956.00 Consultant Fees, Consultant Expenses
HOFFMAN ORLEEN MD 1511 NORTHWAY DR SAINT CLOUD MN 56303 $4,132.88 Consultant Fees, Consultant Expenses
HOLM MARK MD 1900 CENTRACARE CIR SAINT CLOUD MN 56303 $22,432.62 Consultant Fees, Consultant Expenses
HURT RICHARD MD 200 1ST ST SW ROCHESTER MN 55905 $7,500.00 Consultant Fees
INGBAR DAVID MD 420 DELAWARE ST SE MINNEAPOLIS MN 55455 $11,348.79 Consultant Fees, Consultant Expenses
JAMES MICHAEL MD 1230 E MAIN ST MANKATO MN 56001 $1,529.10 Consultant Fees, Consultant Expenses
JOHNSON TODD DDS 5207 UNIVERSITY AVE NE MINNEAPOLIS MN 55421 $800.00 Consultant Fees
KAISER HAROLD MD 825 NICOLLET MALL MINNEAPOLIS MN 55402 $35,677.41 Consultant Fees, Consultant Expenses
KAMMAN LEE MD 255 SMITH AVE N SAINT PAUL MN 55102 $21,622.00 Consultant Fees, Consultant Expenses
KATZ HAROLD MD 255 SMITH AVE N SAINT PAUL MN 55102 $12,342.00 Consultant Fees, Consultant Expenses
KEENAN JOSEPH MD 420 DELAWARE ST SE MINNEAPOLIS MN 55455 $24,480.50 Consultant Fees, Consultant Expenses
KELKAR PRAMOD MD 12000 ELM CREEK BLVD N OSSEO MN 55369 $4,726.00 Consultant Fees, Consultant Expenses
KEMBERLING JASON MD 3366 OAKDALE AVE N MINNEAPOLIS MN 55422 $1,000.00 Consultant Fees
KENNEDY FRANK MD 200 1ST AVE NW ROCHESTER MN 55901 $300.00 Consultant Fees
KHAN FARHA MD 9055 SPRINGBROOK DR NW MINNEAPOLIS MN 55433 $7,800.00 Consultant Fees
KNUTSON CYNTHIA MD 615 S MILL ST FERGUS FALLS MN 56537 $18,000.00 Consultant Fees
KOLODNY LUCIANO MD 1783 WOODLANE DR SAINT PAUL MN 55125 $35,076.45 Consultant Fees, Consultant Expenses
KRIEGLER SAMUEL MD 901 9TH ST N VIRGINIA MN 55792 $3,500.00 Consultant Fees
KROSKA DAVID MD 1900 COUNTY ROAD 134 SAINT CLOUD MN 56303 $3,809.00 Consultant Fees, Consultant Expenses
KUMAR RAJIV MD 200 1ST ST SW Rochester MN 55905 $1,500.00 Consultant Fees
KUROSS STEVEN MD 400 E 3RD ST DULUTH MN 55805 $1,329.43 Consultant Fees, Consultant Expenses
LAEDTKE THOMAS MD 6363 FRANCE AVE S MINNEAPOLIS MN 55435 $11,617.00 Consultant Fees, Consultant Expenses
LARSON ERIC MD 6525 DREW AVE S MINNEAPOLIS MN 55435 $2,405.26 Consultant Fees, Consultant Expenses
LERMAN AMIR MD 200 1ST ST SW ROCHESTER MN 55905 $3,397.76 Consultant Fees, Consultant Expenses
LEVINE TODD MD 910 E 26TH ST MINNEAPOLIS MN 55404 $10,568.40 Consultant Fees, Consultant Expenses
LIEPERT DOUGLAS MD 1528 NORTHWAY DR SAINT CLOUD MN 56303 $3,280.00 Consultant Fees, Consultant Expenses
LOCKHART ROXANNE MD 8675 VALLEY CREEK RD SAINT PAUL MN 55125 $100.00 Consultant Fees
LOWE DAVID MD 210 9TH ST SE ROCHESTER MN 55904 $15,429.00 Consultant Fees, Consultant Expenses
MADAAN ARVIND MD 200 1ST ST SW ROCHESTER MN 55905 $3,903.45 Consultant Fees, Consultant Expenses
MAHR TODD MD 426 E SARNIA ST WINONA MN 55987 $180,388.84 Consultant Fees, Consultant Expenses
MANNCHEN KRISTINE CNP 6405 FRANCE AVE S MINNEAPOLIS MN 55435 $3,788.00 Consultant Fees, Consultant Expenses
MARTINELLI JOSEPH MD 920 E 1ST ST DULUTH MN 55805 $1,750.00 Consultant Fees
MATEO NOE MD 401 PHALEN BLVD SAINT PAUL MN 55101 $1,000.00 Consultant Fees
MEHTA HEMALINI MD 2805 CAMPUS DR MINNEAPOLIS MN 55441 $9,301.00 Consultant Fees, Consultant Expenses
MEYER JAMES MD 6363 FRANCE AVE S MINNEAPOLIS MN 55435 $300.00 Consultant Fees
MEYER LAURA NP 1230 E MAIN ST MANKATO MN 56001 $3,993.00 Consultant Fees, Consultant Expenses
MOENCH JERRY MD 900 2ND AVE MADISON MN 56256 $5,000.00 Consultant Fees
MONTEJO JULIA MD 6341 UNIVERSITY AVE NE MINNEAPOLIS MN 55432 $5,767.00 Consultant Fees, Consultant Expenses
MULMED LAWRENCE MD 710 E 24TH ST MINNEAPOLIS MN 55404 $4,401.00 Consultant Fees, Consultant Expenses
NEHRA AJAY MD 200 1ST ST SW ROCHESTER MN 55905 $3,131.00 Consultant Fees, Consultant Expenses
NELSON MERLIN MD 101 WILLMAR AVE SW WILLMAR MN 56201 $10,680.00 Consultant Fees, Consultant Expenses
NICHOL KRISTIN MD 1 VETERANS DR MINNEAPOLIS MN 55417 $3,500.00 Consultant Fees
OTT NANCY MD 3955 PARKLAWN AVE MINNEAPOLIS MN 55435 $9,850.00 Consultant Fees, Consultant Expenses
PENOVICH PATRICIA MD 310 SMITH AVE N SAINT PAUL MN 55102 $13,109.00 Consultant Fees, Consultant Expenses
PEREZ EDITH MD 200 1ST ST SW ROCHESTER MN 55905 $1,000.00 Consultant Fees
PETERSON KEVIN MD 925 DELAWARE ST SE MINNEAPOLIS MN 55414 $2,420.80 Consultant Fees, Consultant Expenses
POLAND GREGORY MD 200 1ST ST SW ROCHESTER MN 55905 $5,108.00 Consultant Fees, Consultant Expenses
PRATT ALAN MD 3171 STORER VALLEY RD HOUSTON MN 55943 $10,973.00 Consultant Fees, Consultant Expenses
REIMER MARK MD 134 SOUTHVIEW OWATONNA MN 55060 $2,306.16 Consultant Fees, Consultant Expenses
RHAME FRANK MD 1221 W LAKE ST MINNEAPOLIS MN 55408 $9,150.00 Consultant Fees, Consultant Expenses
RIDLEY DAVID MD 1221 W LAKE ST MINNEAPOLIS MN 55408 $1,500.00 Consultant Fees
ROBROCK JOHN MD 1885 PLAZA DR SAINT PAUL MN 55122 $4,000.00 Consultant Fees
ROCK ANN MD 1000 E 1ST ST DULUTH MN 55805 $100.00 Consultant Fees
ROGIN JOANNE MD 4225 GOLDEN VALLEY RD MINNEAPOLIS MN 55422 $13,334.48 Consultant Fees, Consultant Expenses
RUEGEMER JEFFREY MD 6363 FRANCE AVE S MINNEAPOLIS MN 55435 $25,606.00 Consultant Fees, Consultant Expenses
SANDBORN WILLIAM MD 200 1ST ST SW ROCHESTER MN 55905 $1,200.00 Consultant Fees
SANNES MARK MD 3850 PARK NICOLLET BLVD MINNEAPOLIS MN 55416 $3,500.00 Consultant Fees
SCHRIEFER THOMAS MD 910 E 26TH ST MINNEAPOLIS MN 55404 $76,102.00 Consultant Fees, Consultant Expenses
SCHWIETERS BRYAN MD 6525 DREW AVE S MINNEAPOLIS MN 55435 $1,760.86 Consultant Expenses
SEMAKULA CRISPIN MD 701 PARK AVE MINNEAPOLIS MN 55415 $4,050.00 Consultant Fees
SEVERSON MICHAEL MD 2024 S 6TH ST BRAINERD MN 56401 $35,155.40 Consultant Fees, Clinical Trial Fees
SHEIKH FARRUKH MD 1900 CENTRACARE CIRCLE SAINT CLOUD MN 56303 $6,942.00 Consultant Fees, Consultant Expenses
SICILIANO JANET NP 11269 JEFFERSON HWY N CHAMPLIN MN 55316 $1,250.00 Consultant Fees
SIMONELLI CHRISTINE MD 1875 WOODWINDS DR SAINT PAUL MN 55125 $11,691.16 Consultant Fees, Consultant Expenses
SMELTZER DAVID MD 8500 EDINBROOK PKWY MINNEAPOLIS MN 55443 $4,275.00 Consultant Fees, Consultant Expenses
STANG MARK MD 7450 FRANCE AVE S MINNEAPOLIS MN 55435 $8,250.00 Consultant Fees
STILLERMAN ALLAN MD 2805 CAMPUS DR MINNEAPOLIS MN 55441 $12,299.72 Consultant Fees, Consultant Expenses
STORMONT THOMAS MD 1500 CURVE CREST BLVD W STILLWATER MN 55082 $1,700.00 Consultant Fees
STOY PATRICK MD 1027 WASHINGTON AVE DETROIT LAKES MN 56501 $5,300.00 Consultant Fees
SVEUM RICHARD MD 3800 PARK NICOLLET BLVD MINNEAPOLIS MN 55416 $7,300.00 Consultant Fees
SWEET JOHN MD 4625 CHURCHILL ST SAINT PAUL MN 55126 $5,346.00 Consultant Fees, Consultant Expenses
TAYLOR FREDERICK MD 6490 EXCELSIOR BLVD MINNEAPOLIS MN 55426 $28,110.00 Consultant Fees, Consultant Expenses
TIERNEY ROBERT MD 3800 PARK NICOLLET BLVD MINNEAPOLIS MN 55416 $29,683.00 Consultant Fees, Consultant Expenses
TINDALL DONALD MD 200 1ST ST SW ROCHESTER MN 55905 $3,902.15 Consultant Fees, Consultant Expenses
TOBERT DAREN MD 859 MANKATO AVE WINONA MN 55987 $1,674.60 Consultant Fees, Consultant Expenses
TUNIO JAVED MD 8600 NICOLLET AVE S MINNEAPOLIS MN 55420 $2,082.45 Consultant Fees, Consultant Expenses
UTZ WILLIAM MD 6525 FRANCE AVE S # 200 EDINA MN 55435 $8,410.00 Consultant Fees, Consultant Expenses
WYATT RICHARD MD 3800 PARK NICOLLET BLVD MINNEAPOLIS MN 55416 $14,785.00 Consultant Fees, Consultant Expenses
WYMAN JEAN CNP 308 HARVARD ST SE MINNEAPOLIS MN 55455 $1,068.00 Consultant Fees, Consultant Expenses
YASSIN MOHAMED MD 1511 NORTHWAY DR SAINT CLOUD MN 56303 $1,750.00 Consultant Fees
YAWN BARBARA MD 210 9TH ST SE ROCHESTER MN 55904 $629.06 Consultant Fees, Consultant Expenses
ZHANG GANG MD 3900 PARK NICOLLET BLVD MINNEAPOLIS MN 55416 $8,070.00 Consultant Fees, Consultant Expenses
ZIESKE LARRY MD 2805 CAMPUS DR MINNEAPOLIS MN 55441 $33,246.00 Consultant Fees, Consultant Expenses