Notice: This opinion is subject to correction before publication in the PACIFIC REPORTER. 

Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts, 

303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email 

corrections@akcourts.gov. 

THE SUPREME COURT OF THE STATE OF ALASKA 

SETH LOOKHART, 

 Appellant, 

v. 

STATE OF ALASKA, DIVISION OF 

CORPORATIONS, BUSINESS, & 

PROFESSIONAL LICENSING, 

BOARD OF DENTAL EXAMINERS, 

 Appellee. 

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Supreme Court No. S-18466 

perior Court No. 3AN-20-09037 CI

 P I N I O N 

o. 7702 – May 24, 2024 

Su

O

N

Appeal from the Superior Court of the State of Alaska, Third 

Judicial District, Anchorage, Frank A. Pfiffner, Judge. 

Appearances: Chester D. Gilmore, Cashion Gilmore & 

Lindemuth, Anchorage, for Appellant. Robert Kutchin, 

Assistant Attorney General, Anchorage, and Treg R. Taylor, 

Attorney General, Juneau, for Appellee. 

Before: Maassen, Chief Justice, and Carney, Borghesan, 

Henderson, and Pate, Justices. 

PATE, Justice. 

INTRODUCTION 

 The Board of Dental Examiners revoked Seth Lookhart’s dental license 

after he was convicted of dozens of crimes perpetrated in furtherance of a fraudulent 

scheme of staggering proportions that jeopardized the health and safety of his patients. 

Lookhart appealed the Board’s revocation of his license, arguing that his punishment 
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was inconsistent with past Board decisions. On appeal, the superior court concluded 

that the Board properly exercised its discretion by revoking Lookhart’s dental license. 

 We conclude that the Board did not abuse its discretion by revoking 

Lookhart’s license. None of the Board’s prior licensing cases involved misconduct of 

the scope and severity in this case, so there was no applicable precedent to limit the 

Board’s exercise of its discretion. We affirm the decision of the superior court. 

FACTS AND PROCEEDINGS 

A. Lookhart’s Dental Career And Misconduct 

 The facts in this appeal are undisputed. Lookhart was issued an Alaska 

dental license in June 2014 and a parenteral sedation1 permit in May 2015. Between 

May 2016 and March 2017, Lookhart systematically and unnecessarily sedated his 

patients in a manner that allowed him to fraudulently bill the maximum amount covered 

by Alaska’s Medicaid program,

2

 overcharging Medicaid by more than $1.6 million. 

Lookhart routinely billed Medicaid for sedation that was not performed, billed

Medicaid at higher rates than other insurers, and created false dates of service to 

maximize his wrongful reimbursements. During this same period Lookhart also stole 

an additional $412,500 from a business partner. 

 In order to maximize his billings to Medicaid, Lookhart engaged in a 

series of standard-of-care violations: He sedated patients beyond the scope of his 

1

 Parenteral sedation refers here to sedative medications administered 

intravenously, as opposed to in liquid or pill form. 

2

 Alaska Medicaid will pay for dentist-administered general anesthesia or 

sedation if the dentist provides a written medical justification explaining why local 

anesthesia would be “inadequate to control pain.” 7 Alaska Administrative Code 

(AAC) 110.155(a)-(b). The program also requires the dentist to obtain prior 

authorization and submit documentation showing the patient requires the service 

because of a severe disability or “medically compromised condition,” or because of a 

“prolonged or difficult surgical procedure.” Id. 110.155(b) 
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training and permit,3sedated multiple patients simultaneously, billed Medicaid for 

sedation during routine cleanings, and sedated patients with underlying chronic diseases

that made sedation dangerous. He allowed his unlicensed office manager to sedate 

patients, pressured patients into unwanted sedation, and left sedated patients to drive 

themselves home.

On two occasions, Lookhart’s patients nearly lost their lives as a direct 

consequence of his reckless sedation practices: One displayed vital signs “inconsistent 

with signs of life,” while another’s heart rate dropped to 19 beats per minute with what 

Lookhart described as a “crazy high” blood pressure. Lookhart also extracted one 

deeply sedated patient’s tooth while riding a hoverboard, and then sent a video of the 

unsafe extraction to his friends and family members without the patient’s consent.4

Lookhart was fully aware that his conduct was reckless and illegal, but 

declared that the Dental Board “would literally have to be there watching me do it” to 

catch him.

3 Lookhart’s permit only authorized him to perform light-to-moderate 

sedation, but 80% of the time he practiced deep sedation, which carries greater risks.

4 This video went viral, generating national and international headlines. 

See, e.g., Maria Alejandra Pachon Urrego, 12 Años de Cárcel a Odontólogo que Hizo 

‘Acrobacia’ al Sacar Diente, EL TIEMPO (Bogotá) (Sept. 17, 2020, 1:40 PM), 

https://www.eltiempo.com/mundo/eeuu-y-canada/odontologo-hizo-una-acrobacia-alsacar-un-diente-en-estados-unidos-538358; Dentist Jailed After Extracting Tooth 

While on Hoverboard, DAILY NATION (Nairobi) (Sept. 19, 2020), https://nation.africa/

kenya/news/world/dentist-jailed-after-extracting-tooth-while-on-hoverboard-2303146; 

Alaska’da Elektrikli Kaykay Üzerinde diş Çeken diş Hekimine 12 Yıl Hapis Cezası, 

CUMHURIYET (Istanbul) (Sept. 19, 2020), https://www.cumhuriyet.com.tr/

haber/alaskada-elektrikli-kaykay-uzerinde-dis-ceken-dis-hekimine-12-yil-hapiscezasi-1767241. We take judicial notice of these articles under Rule 201 of the Alaska 

Rules of Evidence only to “indicate what was in the public realm at the time, not 

whether the contents of those articles were in fact true.” Von Saher v. Norton Simon 

Museum of Art at Pasadena, 592 F.3d 954, 960 (9th Cir. 2010) (applying analogous 

federal rule).
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Lookhart was arrested in April 2017. After a six-week bench trial ending 

in January 2020, he was convicted on 46 charges, including 11 felony counts of medical 

assistance fraud, three felony counts of scheming to defraud, one count of felony theft, 

three class A misdemeanor counts of reckless endangerment, one class B misdemeanor 

count of failure to meet minimal standards of dentistry, and 27 additional 

misdemeanors. The trial court also issued an order finding that the State had proven 13

sentencing aggravators beyond a reasonable doubt. The trial court found that the 

evidence against Lookhart was “overwhelming.” He was ultimately sentenced to 20 

years in prison with eight years suspended.

5

B. Dental Board Proceedings

Following Lookhart’s convictions, the Division of Corporations, Business

and Professional Licensing filed a 17-count accusation seeking to revoke Lookhart’s 

dental license.6 Lookhart stipulated to the facts contained in the accusation, leaving it 

to an administrative law judge (ALJ) to determine whether revoking his license was an 

appropriate sanction consistent with AS 08.01.075(f).7

The ALJ issued a proposed decision in September 2020. Although the 

ALJ devoted a significant portion of the proposed decision to discussing prior cases of 

the Dental Board, other Alaska licensing boards, and the dental regulators of other 

states, she also rejected the idea that any prior Alaska decision could control the 

outcome of this case. The ALJ found that “there are simply no prior cases of this or 

5 State v. Lookhart, No. 3AN-17-02990 CR (Alaska Super., Sept. 14, 

2020). Lookhart’s appeal in his criminal case is pending in the court of appeals. 

Lookhart v. State, No. A-13752 (Alaska App. filed Oct. 26, 2020).

6 See AS 44.62.360.

7 AS 08.01.075(f) obligates licensing boards to “seek consistency in the 

application of disciplinary sanctions” and “explain a significant departure from prior 

decisions involving similar facts in the order imposing the sanction.”
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any other Alaska board involving facts that are truly comparable to those presented 

here.”

The ALJ concluded that Lookhart’s “astonishing range of misconduct” 

was “more wide-ranging and severe” than in any prior case in which the Board imposed 

a lesser sanction. Revocation, the ALJ wrote, “would be justified if the only misconduct 

here was the Medicaid fraud”; “might have been justified if the only misconduct here 

was the theft”; and “would also have been justified if the only misconduct here was the 

numerous standard of care violations.” Taken as a whole, the ALJ concluded that 

revocation was the “clear and obvious sanction,” adopting the Division’s contention

that, “[i]f this case does not require it, no future case will.”

The Board adopted the ALJ’s decision without modification.

C. The Superior Court’s Decision

Lookhart appealed to the superior court, arguing that the Board’s decision 

was inconsistent with its prior decisions revoking dental licenses. The court concluded 

that AS 08.01.075(f) affords the Board “wide discretion” to determine appropriate 

sanctions, rejecting Lookhart’s argument that it was narrowly constrained by the two 

prior Board cases that resulted in revocation. The court reasoned that even if it accepted 

Lookhart’s argument that the Board’s decision departed from precedent, the Board

provided an adequate explanation justifying its decision in this case, which is all that 

AS 08.01.075(f) requires.

The court noted that “no Alaska case is factually comparable to the sheer 

scale of malfeasance here,” that the Board “painstakingly detailed” Lookhart’s 

misconduct, and that it had “carefully considered and rejected any comparison with 

prior Board cases.” Although the court stated that Lookhart did not challenge the 

adequacy or logic of the Board’s decision, it concluded that the Board’s decision to 

revoke his dental license was a proper exercise of its discretion. The superior court thus

affirmed the Board’s decision in full.
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Lookhart appeals.

STANDARDS OF REVIEW

“When a superior court acts as an intermediate court of appeals reviewing 

an administrative or agency decision, we independently review the merits of the 

administrative decision, giving no deference to the superior court’s decision.”8 We

review an “agency’s factual findings to determine whether they are supported by 

substantial evidence.”9 The substantial evidence test is highly deferential and considers 

evidence substantial if it is “such relevant evidence as a reasonable mind might accept 

as adequate to support a conclusion.”10 This level of deference “reflects the prudence 

of deferring to a state professional board’s special competence in recognizing violations 

of professional standards.”11

We review questions of law implicating agency expertise, such as an 

agency’s selection of a particular sanction, using the reasonable basis test.

12

 Under this 

8 Odom v. State, Div. of Corps., Bus. & Prof. Licensing, 421 P.3d 1, 6

(Alaska 2018) (first citing Jurgens v. City of North Pole, 153 P.3d 321, 325 (Alaska 

2007); and then citing State, Dep’t of Revenue v. Merriouns, 894 P.2d 623, 625 (Alaska 

1995)).

9

Id. (citing Jurgens, 153 P.3d at 325).

10 Id. (quoting Storrs v. State Med. Bd., 664 P.2d 547, 554 (Alaska 1983)).

11 Id. (quoting State, Dep’t of Com., Cmty. & Econ. Dev., Div. of Corps., 

Bus. & Prof’l Licensing v. Wold, 278 P.3d 266, 273 (Alaska 2012)).

12 Fantasies on 5th Avenue, LLC v. Alcoholic Beverage Control Bd., 446 

P.3d 360, 367 (Alaska 2019). In their briefing the parties relied on our statement in

Odom v. State, Division of Corps., Business & Professional Licensing, 421 P.3d at 6,

that “we review the agency’s selection of a particular disciplinary sanction for abuse of 

discretion.” This statement in Odom must be understood as representing the inquiry we 

make within the context of the reasonable basis test. We take this opportunity to clarify 

that the appropriate standard for reviewing agency decisions that implicate agency 

expertise is the reasonable basis standard. See, e.g., Wendte v. State, Bd. of Real Est. 

Appraisers, 70 P.3d 1089, 1091 (Alaska 2003); State, Div. of Corps., Bus. & Prof. 

Licensing, Alaska Bd. of Nursing v. Platt, 169 P.3d 595, 598 (Alaska 2007).
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standard, “we ask ‘whether there was a prejudicial abuse of discretion,’ which we will 

find ‘if the agency has not proceeded in the manner required by law, the order or 

decision is not supported by the findings, or the findings are not supported by the 

evidence.’ ”

13

We apply our “independent judgment” when interpreting the meaning of 

a statute that “does not ‘implicate an agency’s special expertise or determination of 

fundamental policies.’ ”

14

DISCUSSION

Lookhart argues that AS 08.01.075(f) narrowly circumscribes the Board’s 

authority to revoke licenses and that the revocation of his license was inconsistent with 

the Board’s prior decisions. Both arguments lack merit. While AS 08.01.075(f) 

obligates the Board to “seek consistency” with its prior decisions, there is simply no 

prior case comparable to the scope of Lookhart’s egregious dishonesty and misconduct. 

The Board did not abuse its discretion in concluding that revoking Lookhart’s license

was an appropriate sanction.

A. Alaska Statute 08.01.075(f) Affords The Dental Board The Flexibility 

To Craft Appropriate Sanctions In Response To Novel 

Circumstances.

Alaska Statute 08.01.075(f) provides that the Board of Dental Examiners 

“shall seek consistency in the application of disciplinary sanctions.” Throughout his 

briefing, Lookhart insists that “Board decisions must be consistent with prior 

precedent” and argues the statutory framework and the Board’s prior decisions allow

the Board to revoke a license only when two conditions are met: (1) the dentist shows 

“contempt for the Board’s ability to discipline” by refusing to accept responsibility or 

13 Fantasies on 5th Avenue, 446 P.3d at 367 (quoting AS 44.62.570(b)(3)).

14 Rosauer v. Manos, 440 P.3d 145, 147-48 (Alaska 2019) (quoting Mun. of 

Anchorage v. Suzuki, 41 P.3d 147, 150 (Alaska 2002)).
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adhere to conditions of prohibitions, and (2) the dentist either fraudulently prescribes 

medicine while exhibiting addictive behaviors or causes “extreme patient harm.”15 

Lookhart argues that he did not do either of these things, making revocation an 

inconsistent sanction in his case.

If we were to adopt Lookhart’s understanding of the Board’s statutory 

mandate, it would artificially limit the ability of the Board to craft appropriate sanctions 

in response to new factual situations. The Board is obligated to “seek consistency” 

between cases involving similar facts. But it is not obligated to operate strictly within 

the bounds of existing precedent when a case presents novel circumstances. Lookhart’s

interpretation of AS 08.01.075 cannot be squared with the language of the statute or the 

surrounding provisions. 

Alaska Statute 08.01.075(f) provides that the Board “shall seek 

consistency” in applying disciplinary sanctions. The U.S. Court of Appeals for the First 

Circuit has interpreted the use of “shall seek” rather than “shall” as reflecting clear 

legislative intent “to require only that the [agency] take reasonable, affirmative steps” 

toward the statute’s goal.

16 We agree with the First Circuit’s reasoning and decline to 

read the words “shall seek” to impose the strict mandate that Lookhart proposes. 

15 See In re Greenough, OAH Nos. 1200-94-006 & 1200-96-5 (Dec. 22, 

1998), https://aws.state.ak.us/OAH/Decision/Display?rec=6585 (concluding dentist’s 

misconduct while on probation provided “a basis for revocation”); In re Robinson, OAH 

No. 1200-95-013, at 8-9 (Sept. 13, 1996), https://aws.state.ak.us/

OAH/Decision/Display?rec=6583 (revoking license where dentist fraudulently 

prescribed medication “for the purpose of maintaining [a person’s] addiction to drugs”); 

Smith v. State, Bd. of Dental Exam’rs, No. 7806, 1984 WL 908389, at *1, *3 (Alaska 

May 2, 1984) (affirming Board’s decision to revoke license after “willful and gross 

malpractice or negligence”).

16 Conille v. Sec’y of Hous. & Urb. Dev., 840 F.2d 105, 112-13 & n.12 (1st 

Cir. 1988) (noting that, absent clearly expressed contrary legislative intent, “shall seek” 

does not mean “shall”).
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Moreover, AS 08.01.075(f) explicitly recognizes that the Board may depart from its 

prior decisions, provided that the Board “explain[s] a significant departure from prior 

decisions involving similar facts.” While consistency is a goal that the Board is 

obligated to seek, the statute affords the Board significant discretion in fashioning an 

appropriate sanction.

The statutory scheme of dental licensing also weighs against Lookhart’s 

reading. Alaska Statute 08.36.315 sets forth a list of fourteen conditions, any of which 

may justify the Board’s decision to “revoke or suspend the license of a dentist.” But 

Lookhart argues that only instances of demonstrated “contempt for the Board’s ability 

to discipline” and either fraudulent prescriptions or “extreme patient harm” may justify 

the decision to revoke a dental license. This reading would render several sections of 

AS 08.36.315 effectively superfluous. As relevant to this case, subsections .315(1) and 

(2), which provide for license revocation in cases of fraud, and subsection .315(6), 

providing the same for standard-of-care violations, would be rendered meaningless.

Lookhart’s reliance on Odom v. State, Division of Corps., Business &

Professional Licensing17 is misplaced. In Odom, the Medical Board revoked a doctor’s 

license after a single case of inappropriate prescribing.18 The Medical Board in Odom

provided no explanation of why its decision to revoke was consistent with its prior 

cases.

19

 We concluded that the Medical Board, by adopting a decision that “contain[ed] 

no findings of its own” and providing no written explanation for its decision to revoke 

Odom’s license, failed to comply with its statutory duty to either “be consistent in the 

application of disciplinary sanctions” or explain an inconsistency.20

17 421 P.3d 1.

18 Id. at 3-6.

19 Id. at 8.

20 Id. at 9 (citing AS 08.64.331(f)).
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Unlike in Odom, the Dental Board here adopted a detailed order setting 

forth its rationale for revocation. Unlike the Medical Board in Odom, which failed to 

reference prior decisions involving similar facts, the Dental Board considered a range 

of past decisions and concluded that none were comparable to the facts and 

circumstances of Lookhart’s case. It examined each of the decisions put forward by 

Lookhart and provided a detailed explanation of why its decision to revoke was 

consistent with its prior decisions. The errors present in Odom simply do not appear in 

the Board’s decision in this case.

The Board is obligated to “seek consistency” in its disciplinary 

decisions.21 But this obligation does not trap the Board in amber, rendering it unable to

respond appropriately to the unique facts and circumstances presented in each case. 

Lookhart’s interpretation of this requirement would effectively strip the Board of a 

significant range of its statutory powers, while also hindering its ability to adapt to

evolving professional standards. The Board must be afforded the flexibility to craft 

appropriate sanctions in response to novel factual circumstances, such as those 

presented in this case. Alaska Statute 08.01.075(f) affords the Board this flexibility.

B. No Prior Dental Board Decision Involves Similar Facts.

The Board is obligated to “seek consistency in the application of 

disciplinary sanctions” and “explain a significant departure from prior decisions 

involving similar facts.”22

The Board found that “there are simply no prior cases of this or any other 

Alaska board involving facts that are truly comparable to those presented here,” because 

Lookhart’s conduct was “more wide-ranging and severe than in any [prior] cases.” The 

21 AS 08.01.075(f).

22 Id.
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superior court likewise concluded that “no Alaska case is factually comparable to the 

sheer scale of malfeasance here.”

We agree. Lookhart stole millions of dollars from the state program that 

provides medical care for the indigent, while simultaneously defrauding a business 

partner of several hundred thousand more, and committing an egregious string of 

standard-of-care violations that not only jeopardized the safety, privacy, and autonomy 

of his patients, but also brought the dental profession into disrepute. The lack of any 

comparable previous case meant that the Board was free to use its expertise to determine 

an appropriate sanction that would deter future misconduct and restore public trust, 

based on the unique facts and circumstances of this case.

Although Lookhart cites a string of prior Board decisions as addressing 

similar circumstances, none bear more than a superficial resemblance to his own case. 

In re Greenough,

23 which Lookhart argues is the Board decision “that bears the most 

comparable relationship to the current case,” involved a dentist whose license was 

suspended for two years following an insurance fraud conviction.24 But Greenough

defrauded several insurers of roughly $5,000;25 whereas Lookhart stole $1,600,000, or 

over 300 times that amount, and committed a series of other wrongful acts in 

combination with his billing fraud.

Likewise, Lookhart argues that revocation of his license is inconsistent 

with In re Houseman, a case in which a dentist was given a two-week suspension for a 

23 OAH Nos. 1200-94-006 & 1200-96-5 (Dec. 22, 1998), 

https://aws.state.ak.us/OAH/Decision/Display?rec=6585.

24 Id. at 20-21, 59-60.

25 See id. at 20-21. The Board also observed that Greenough’s misconduct 

would “provide a basis for revocation,” but declined to consider revocation because the 

State only sought a suspension. Id. at 57.
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negligent procedure.26 Lookhart suggests that he “did not cause the kind of actual 

serious harm to patients” that Houseman did. But Houseman committed a single 

negligent procedure, while Lookhart nearly killed two of his patients and recklessly 

endangered the lives of others — and did so in the course of committing extensive

Medicaid fraud, an element that has no equivalent in Houseman. The Board did not 

abuse its discretion by concluding that the magnitude of Lookhart’s conduct merited a 

harsher sanction than it imposed in In re Greenough and In re Houseman.

Finally, Lookhart points to the superior court decision in Ness v. State27

for the proposition that the Board’s sanctions may not impose “pure punishment.” In 

Ness, the superior court concluded that a four-month suspension was an unduly harsh 

penalty for “a first case of improper procedure in a seventeen year career.”28 The court 

explained that this penalty “seem[ed] to constitute unwarranted and unnecessary 

punishment” that did not further the goals of protecting the public or instilling public 

respect and confidence.29 But unlike Ness’s single error, Lookhart committed a “litany 

of bad acts,” which “began at virtually the start of his career and continued until he was 

caught and arrested.” The Board accordingly concluded that a more severe penalty was 

necessary, not to punish Lookhart, but to deter misconduct, “ensure public safety and 

restore trust to the profession.”

Lookhart stole millions of dollars from Medicaid. In furtherance of this 

massive fraud, he repeatedly subjected his patients to great risk of harm. There are no 

cases in the Board’s history comparable to Lookhart’s. In light of the lack of any cases 

26 OAH No. 1200-89-00011 at 12-15, 19-20 (June 14, 1990), 

https://aws.state.ak.us/OAH/Decision/Display?rec=6584.

27 Ness v. State, Bd. of Dental Exam’rs, No. 3AN-06-8587 CI (Alaska 

Super., Apr. 28, 2008), https://aws.state.ak.us/OAH/Decision/Display?rec=6581.

28 Id. at 2.

29 Id. at 6.
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presenting similar facts or circumstances, the Board’s conclusion that revocation was 

the “clear and obvious sanction” given the “sheer magnitude of admitted misconduct” 

was not an abuse of discretion.

CONCLUSION

The judgment of the superior court is AFFIRMED.