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Appendix

Profile

License Number: A0000329 Maureen Kimberly Siburt
License Type: Athletic Trainer
License Status: Active
License Issued: 11/04/2011 License Expiration: 09/30/2027

Licensure Pathway: Traditional
Special License Category: N/A

Primary Practice Setting

N/A

Public Address

7303 River Road
Bethesda, MD 20817

Education

N/A

Medical Assistance

Accept Medicaid? N/A

Medical Licenses Held in Other States (as reported by licensee)

South Carolina

Virginia

Active Supervisee - Evaluation and Treatment Protocols for Athletic Trainers

D0068951 Samuel Mark Sanders Status: Approved | Approved Date: 10/27/2011 | Agreement No: 1067

D0064176 Jonas Ronon Rudzki Status: Approved | Approved Date: 12/18/2019 | Agreement No: 1753

Download all Maryland Disciplinary Actions (not time-limited)

All Orders are downloaded in .pdf format.

None.

Summary of Known Disciplinary Actions by any state medical board (within the past 10 years) Please Read Description

In Maryland:

No Known Disciplinary Actions by the Maryland Board of Physicians have been reported.

Other States:

No Known Disciplinary Actions by any other state medical board have been reported.

Pending Charges Please Read Disclaimer

All Charges are downloaded in .pdf format.

None.

Other Public Actions in the Practice of the Profession or Administrative Fines (including Maryland) Please Read Description

No reported Other Public Actions in the Practice of the Profession or Administrative Fines (incl. Maryland) for this licensee.

Convictions for any crime involving moral turpitude

None reported by the courts.

Appendix

General Disclaimer

Glossary of Terms

Notice to Credential Verification Professionals

Conceded Eminence	A physician who has demonstrated significant teaching, research, and achievement in the field of medicine and has been recommended to the Board by the dean of a school of medicine or the director of the National Institutes of Health. A physician who is licensed by conceded eminence may only practice at the institutions approved by the Board.
Volunteer	Practice limited solely to providing medical services to patients in Maryland without compensation.
Limited License for Postgraduate Teaching (LLPGT)	A postgraduate teaching license means the physician shall: Only practice within the teaching institutions and programs specified within the application; Practice medicine only in conjunction with the applicant's teaching responsibilities; and Not practice medicine outside the applicant's teaching responsibilities.
License by Reciprocity	The Maryland Board of Physicians (the Board) will issue a license by reciprocity to physicians who have an active, unrestricted license in Virginia and are an American Medical Graduate, or have an active, unrestricted license in the District of Columbia. The applicant must meet other minimum qualifications for licensure such as good moral character.
License by Endorsement	The Maryland Board of Physicians (the Board) will issue a license by Endorsement to physicians who have at least one current, unrestricted license in good standing for the 4 years immediately preceding the application, current Board Certification, and no current or past disciplinary actions. The applicant must meet other minimum qualifications for licensure such as good moral character.
Physician Assistant License by Reciprocity	The Maryland Board of Physicians (the Board) will issue a license by reciprocity to physician assistants who have an active, unrestricted license in Virginia or the District of Columbia. The applicant must meet other minimum qualifications for licensure such as good moral character.
Physician Assistant License by Endorsement	The Maryland Board of Physicians (the Board) will issue a license by Endorsement to physician assistants who have at least one current, unrestricted license in good standing for the 5 years immediately preceding the application, and no current or past disciplinary actions. The applicant must meet other minimum qualifications for licensure such as good moral character.
Compact	A physician who lives in a state participating in the Interstate Medical Licensure Compact (IMLC) can apply for a license in other participating IMLC states.
Compact Conversion	A physician who obtained an initial Maryland license through the Interstate Medical Licensure Compact (IMLC) but who converted to have a Maryland license outside of the IMLC.
Naturopathic Doctor License by Reciprocity	The Maryland Board of Physicians (the Board) will issue a license by reciprocity to qualified Naturopathic Doctors. The applicant must meet other minimum qualifications for licensure such as good moral character.
Traditional	A practitioner who obtained an initial Maryland license/registration through either a paper application or the online application.

Acupuncture Registration	Physician has completed at least 200 hours of instruction in a medical acupuncture program and is registered with the Board to perform acupuncture in Maryland (COMAR 10.32.15.01).
Certifying Provider with the Maryland Medical Cannabis Commission (MMCC)	For more information, please visit the MMCC's website at https://mmcc.maryland.gov.
Nuclear Medicine Technologists (NMT) Approved to Operate Standalone/Hybrid CT Devices for Diagnostic CT	May operate a standalone CT or hybrid nuclear medicine/CT device for a diagnostic CT with or without intravenous contrast with the following qualifications: Successfully passed the ARRT or NMTCB specialty exam for CT; and Administers contrast media after consultation with, and under the supervision of, a physician who is immediately and physically available. In addition, the Board requires that all NMTs who intend to perform diagnostic CT complete and submit the Notification of Intent of a Nuclear Medicine Technologist (NMT) to Perform Diagnostic CT form to the Board.