Federal Register / Vol. 74, No. 22 / Wednesday, February 4, 2009 / Notices 6059 

4Even if some States authorize a physician to 

prescribe in some circumstances based on a 

physical exam performed by a nurse, Respondent 

was required to comply with the law of every State 

in which his patients resided. In any event, 

Respondent did not establish that his prescribing 

was lawful under the law of any State. 

5 It is acknowledged that the States generally 

allow a practitioner to issue a prescription in an 

emergency situation before conducting a physical 

exam. See 49 Pa. Code § 16.92(a). Some States also 

allow a practitioner to issue a short term 

continuation prescription for a new patient prior to 

a patient’s first appointment, in an order admitting 

a patient to a hospital, or for a patient of another 

physician for whom the prescriber is taking calls. 

Tenn. Comp. R. & Regs. 0880–2-.14(7)(b). None of 

these exceptions apply here. 

6 I reject as self-serving Respondent’s assertion 

that he believed that ‘‘a good proportion of [the] 

people [he prescribed to] actually needed help’’ 

because their original doctors had become ‘‘weary’’ 

of continuing to prescribe narcotics to them. 

Notably, Respondent did not identify a single 

instance in which he contacted the original 

physicians of the patients to even determine 

whether a patient had a legitimate medical 

condition which required the continued prescribing 

of a controlled substance. As Respondent himself 

recognized, internet prescribing invites ‘‘doctor 

hopping’’ and ‘‘medication shopping’’ by drug 

abusers and drug dealers. In short, as this Agency 

has found in the course of numerous investigations, 

the risk of diversion inherent in internet prescribing 

is extraordinary. 

7 In his request for a hearing, Respondent 

‘‘disagreed * * * that [the] prescriptions were 

issued without a legitimate medical purpose and 

outside the usual course of professional practice.’’ 

While Respondent’s counsel further represented 

that he did not intend to ‘‘practic[e] medicine in 

any way related to an Internet pharmacy,’’ 

Respondent has not satisfied the Agency’s standard 

for obtaining a new registration, which requires that 

an applicant accept responsibility for his 

misconduct and acknowledge his wrongdoing. See, 

e.g., Medicine Shoppe—Jonesborough, 73 FR 364, 

387 (2008) (collecting cases), aff’d, Medicine 

Shoppe-Jonesborough v. DEA, slip op. at 9–10 (6th 

Cir. Nov. 13, 2008); Hoxie v. DEA, 419 F.3d 477, 

483 (6th Cir, 2005) (‘‘admitting fault’’ is ‘‘properly 

consider[ed]’’ by DEA to be an ‘‘important factor[]’’ 

in the public interest determination). 

establishment of a valid physician/ 

patient relationship’ * * *. The 

members of the Oklahoma Medical 

Board have interpreted that a ‘sufficient 

examination’ and ‘establishment of a 

valid physician/patient relationship’ 

cannot take place without an initial face 

to face encounter with the patient.’’) 

(emphasis in original and quoting Okla. 

Stat. tit. 59, section 509–13). 

No more persuasive is Respondent’s 

contention that his prescribings were 

lawful because the clinic used nurses or 

paramedics to perform physical 

examinations. Respondent did not 

provide any evidence to the Agency that 

the clinic’s purported use of nurses to 

perform physical examinations was a 

lawful practice under the exceptions 

recognized by any State.4

Moreover, Respondent admitted to the 

Investigators that he routinely 

prescribed before he obtained medical 

records and in some cases he never 

reviewed records. Thus, even if some 

States allowed a physician to prescribe 

based on an exam performed by a nurse 

or paramedic in certain defined 

circumstances, a physical examination 

is a prerequisite to establishing a valid 

doctor-patient relationship. See Tenn. 

Comp R. & Regs 0880–2-.14(7). 

Generally, reviewing an examination 

conducted after the issuance of a 

prescription is not the usual course of 

professional practice.5 I thus conclude 

that Respondent lacked a legitimate 

medical purpose and acted outside of 

the usual course of professional practice 

in issuing the prescriptions. 

Respondent’s prescribing practices 

clearly resulted in the diversion of 

controlled substances. As Respondent 

acknowledged in the interview, ‘‘there 

were quite a few [patients] that [were] 

just doctor hopping or * * * shopping 

for medication.’’ 6 Indeed, as the record 

establishes, Respondent prescribed to 

two people who used falsified records 

and the driver’s licenses of other 

persons, to obtain such highly abused 

controlled substances as hydrocodone 

and alprazolam, which they both 

personally abused and sold to others. 

Given the thousands of prescriptions he 

issued in this manner, there were likely 

numerous other instances in which he 

prescribed to persons who were seeking 

the drugs for illicit purposes. 

It is therefore clear that Respondent 

committed acts which establish that 

granting him a new registration would 

be ‘‘inconsistent with the public 

interest.’’ 21 U.S.C. 823(f).7

Respondent’s application will therefore 

be denied. 

Order 

Pursuant to the authority vested in me 

by 21 U.S.C. 823(f), as well as 28 CFR 

0.100(b) & 0.104, I order that the 

application of Ladapo O. Shyngle, M.D., 

for a DEA Certificate of Registration as 

a practitioner be, and it hereby is, 

denied. This order is effective March 6, 

2009. 

Dated: January 27, 2009. 

Michele M. Leonhart, 

Deputy Administrator. 

[FR Doc. E9–2331 Filed 2–3–09; 8:45 am] 

BILLING CODE 4410–09–P 

DEPARTMENT OF JUSTICE 

Drug Enforcement Administration 

[Docket No. 06–72] 

Foothills Family Pharmacy (Boulder) 

and Foothills Family Pharmacy 

(Lafayette); Declaratory Order 

Terminating Registrations 

On August 14, 2006, the Deputy 

Assistant Administrator, Office of 

Diversion Control, issued an Order to 

Show Cause to Foothills Family 

Pharmacy of Boulder, Colorado, and 

Foothills Family Pharmacy of Lafayette, 

Colorado (Respondents). The Order 

proposed the revocation of each 

Respondent’s DEA Certificate of 

Registration as a retail pharmacy, and 

the denial of any applications filed by 

either Respondent to renew or modify 

its registration, on the ground that each 

Respondent’s ‘‘continued registration 

would be inconsistent with the public 

interest.’’ Show Cause Order at 1. More 

specifically, the Order alleged that each 

pharmacy had violated its 

‘‘corresponding responsibility’’ under 

Federal law by filling prescriptions for 

controlled substances which were 

unlawful because they were not 

‘‘ ‘issued for a legitimate medical 

purpose by an individual practitioner 

acting in the usual course of his 

professional practice.’ ’’ Id. at 3 (quoting 

21 CFR 1306.04(a)). 

Respondents requested a hearing on 

the allegations, and the matter was 

placed on the docket of the Agency’s 

Administrative Law Judges (ALJ). 

Following prehearing procedures, the 

parties agreed to submit documents and 

written statements of position to the ALJ 

in lieu of a trial-type hearing. 

Subsequent to their filings, the parties 

also submitted briefs containing their 

proposed conclusions of law and 

arguments. 

On June 20, 2008, the ALJ issued her 

recommended decision. In her decision, 

the ALJ concluded that the Government 

had established that each ‘‘Respondent’s 

continued registration would be 

inconsistent with the public interest.’’ 

ALJ at 42. The ALJ thus recommended 

that each Respondent’s registration be 

revoked and that any pending 

applications be denied. The record was 

then forwarded to me for final agency 

action. 

Thereafter, the Government obtained 

information that each Respondent was 

closed and no longer conducting 

business. Gov. Mot. for Declaratory 

Order at 2. Accordingly, the 

Government filed a motion seeking an 

order declaring each Respondent’s 

registration terminated on the ground 

6060 Federal Register / Vol. 74, No. 22 / Wednesday, February 4, 2009 / Notices 

that they had gone out of business. Id. 

Attached to the motion was the 

Affidavit (Dated 10/16/08) of a DEA 

Diversion Investigator. In her Affidavit, 

the Investigator stated that on 

September 4, 2008, she had spoken with 

the Program Director of the Colorado 

Board of Pharmacy and had been told 

that the Foothills Family Pharmacy of 

Lafayette had been closed since January 

2008. Affidavit at 1–2. The Investigator 

further stated that she had also spoken 

with an Inspector for the Colorado 

Board who advised her that Calvin 

Tyree, the owner of Foothills Family 

Pharmacy of Boulder, had submitted the 

document required to close the 

pharmacy. Id. at 2. The Investigator 

further stated that she had confirmed 

the latter pharmacy’s closing with some 

of its former employees. Id. 

On November 18, 2008, I issued an 

Order granting Respondents fifteen days 

to respond to the Government’s motion. 

Neither Respondent has filed a 

response. 

Based on the Affidavit, I find that 

each Respondent has discontinued 

business or professional practice. Under 

21 CFR 1301.52, ‘‘the registration of any 

person shall terminate if and when such 

person dies, ceases legal existence, or 

discontinues business or professional 

practice.’’ Accordingly, I will grant the 

Government’s motion and declare that 

each Respondent’s registration has 

terminated. I will also order that any 

pending applications submitted by 

either Respondent be denied. 

Order 

Pursuant to the authority vested in me 

under 5 U.S.C. 554(e), as well as 28 CFR 

0.100(b) & 0.104, I grant the 

Government’s motion and hereby 

declare terminated DEA Certificate of 

Registration, BF8528361, issued to 

Foothills Family Pharmacy of Boulder, 

Colorado, and DEA Certificate of 

Registration, BF8933334, issued to 

Foothills Family Pharmacy of Lafayette, 

Colorado. I further order that any 

pending applications of Foothills 

Family Pharmacy of Boulder, Colorado, 

and Foothills Family Pharmacy of 

Lafayette, Colorado, be, and they hereby 

are, denied. This Order is effective 

immediately. 

Dated: January 27, 2009. 

Michele M. Leonhart, 

Deputy Administrator. 

[FR Doc. E9–2330 Filed 2–3–09; 8:45 am] 

BILLING CODE 4410–09–P 

NUCLEAR REGULATORY 

COMMISSION 

[Docket No. 50–302; NRC–2009–0039]] 

Florida Power Corporation Notice of 

Receipt and Availability of Application 

for Renewal of Crystal River Unit 3 

Nuclear Generating Plant Facility 

Operating License No. DPR–72 for an 

Additional 20-Year Period 

The U.S. Nuclear Regulatory 

Commission (NRC) has received an 

application, dated December 16, 2008, 

from Florida Power Corporation, filed 

pursuant to Section 104b of the Atomic 

Energy Act of 1954, as amended, and 

Title 10 of the Code of Federal 

Regulations Part 54 (10 CFR Part 54), to 

renew the operating license for the 

Crystal River Unit 3 Nuclear Generating 

Plant (CR–3). Renewal of the license 

would authorize the applicant to 

operate the facility for an additional 20- 

year period beyond the period specified 

in the current operating license. The 

current operating license for CR–3 

expires on December 3, 2016. CR–3 is a 

pressurized-water reactor designed by 

Combustion Engineering that is located 

in Citrus County, Florida. The 

acceptability of the tendered application 

for docketing, and other matters 

including an opportunity to request a 

hearing, will be the subject of 

subsequent Federal Register notices. 

Copies of the application are available 

to the public at the Commission’s Public 

Document Room (PDR), located at One 

White Flint North, 11555 Rockville 

Pike, Rockville, Maryland 20852 or 

through the internet from the NRC’s 

Agencywide Documents Access and 

Management System (ADAMS) Public 

Electronic Reading Room under 

Accession Number ML090080053. The 

ADAMS Public Electronic Reading 

Room is accessible from the NRC Web 

site at http://www.nrc.gov/reading-rm/ 

adams.html. In addition, the application 

is available at http://www.nrc.gov/ 

reactors/operating/licensing/renewal/ 

applications.html. Persons who do not 

have access to the Internet or who 

encounter problems in accessing the 

documents located in ADAMS should 

contact the NRC’s PDR reference staff at 

1–800–397–4209, extension 4737, or by 

e-mail to pdr@nrc.gov. 

A copy of the license renewal 

application for CR–3 is also available to 

local residents near the site at the 

Coastal Region Library, 8619 W. Crystal 

St., Crystal River, FL 34428–4468. 

Dated at Rockville, Maryland, this 29th day 

of January, 2009. 

For the Nuclear Regulatory Commission. 

Brian E. Holian, 

Director, Division of License Renewal, Office 

of Nuclear Reactor Regulation. 

[FR Doc. E9–2323 Filed 2–3–09; 8:45 am] 

BILLING CODE 7590–01–P 

NUCLEAR REGULATORY 

COMMISSION 

[Docket No. 030–36545; NRC–2009–0038] 

Notice of Availability of Environmental 

Assessment and Finding of No 

Significant Impact for License 

Amendment to Byproduct Materials 

License No. 29–30906–01, for 

Unrestricted Release of the Signum 

Biosciences, Inc.’s Facility in 

Monmouth Junction, NJ 

AGENCY: Nuclear Regulatory 

Commission. 

ACTION: Issuance of Environmental 

Assessment and Finding of No 

Significant Impact for License 

Amendment. 

FOR FURTHER INFORMATION CONTACT: 

Steve Hammann, Health Physicist, 

Commercial and R&D Branch, Division 

of Nuclear Materials Safety, Region I, 

475 Allendale Road, King of Prussia, 

Pennsylvania; telephone 610–337–5399; 

fax number 610–337–5269; or by e-mail: 

stephen.hammann@nrc.gov. 

SUPPLEMENTARY INFORMATION: 

I. Introduction 

The U.S. Nuclear Regulatory 

Commission (NRC) is considering the 

issuance of a license amendment to 

Byproduct Materials License No. 29– 

30906–01. This license is held by 

Signum Biosciences, Inc. (Licensee), for 

its facility located at 1 Deer Park Drive 

in Monmouth Junction, New Jersey 

(Facility). Issuance of the amendment 

would authorize release of the Facility 

for unrestricted use. The Licensee 

requested this action in a letter dated 

April 14, 2008. The NRC has prepared 

an Environmental Assessment (EA) in 

support of this proposed action in 

accordance with the requirements of 

Title 10, Code of Federal Regulations 

(CFR), Part 51 (10 CFR Part 51). Based 

on the EA, the NRC has concluded that 

a Finding of No Significant Impact 

(FONSI) is appropriate with respect to 

the proposed action. The amendment 

will be issued to the Licensee following 

the publication of this FONSI and EA in 

the Federal Register.