Federal Register / Vol. 87, No. 69 / Monday, April 11, 2022 / Notices 21165 

*A I have made minor modifications to the RD. I 

have substituted initials or titles for the names of 

witnesses and patients to protect their privacy and 

I have made minor, nonsubstantive, grammatical 

changes and nonsubstantive, conforming edits. 

Where I have made substantive changes, omitted 

language for brevity or relevance, or where I have 

added to or modified the ALJ’s opinion, I have 

noted the edits with an asterisk, and I have 

included specific descriptions of the modifications 

in brackets following the asterisk or in footnotes 

marked with a letter and an asterisk. Within those 

brackets and footnotes, the use of the personal 

pronoun ‘‘I’’ refers to myself—the Administrator. 

*B I have omitted the RD’s discussion of the 

procedural history to avoid repetition with my 

introduction. 

exist, an Applicant must convince the 

Administrator that his acceptance of 

responsibility is sufficiently credible to 

ensure that his misconduct will not 

reoccur and that he can be entrusted 

with registration. I find that Applicant 

has not met this burden. In sum, 

Applicant has not offered any credible 

evidence on the record to rebut the 

Government’s case for denial of his 

application and Applicant has not 

demonstrated that he can be entrusted 

with the responsibility of registration. 

Accordingly, I will order the denial of 

Applicant’s application below. 

Order 

Pursuant to 28 CFR 0.100(b) and the 

authority vested in me by 21 U.S.C. 

823(f) and 21 U.S.C. 824(a), I hereby 

deny the pending application for a 

Certificate of Registration, Control 

Number W19032408C, submitted by 

Kareem Hubbard, M.D., as well as any 

other pending application of Kareem 

Hubbard, M.D. for additional 

registration in California. This Order is 

effective May 11, 2022. 

Anne Milgram, 

Administrator. 

[FR Doc. 2022–07702 Filed 4–8–22; 8:45 am] 

BILLING CODE 4410–09–P 

DEPARTMENT OF JUSTICE 

Drug Enforcement Administration 

[Docket No. 20–17] 

Noah David, P.A.; Decision and Order 

On March 9, 2020, a former Assistant 

Administrator, Diversion Control 

Division, of the Drug Enforcement 

Administration (hereinafter, DEA or 

Government), issued an Order to Show 

Cause (hereinafter, OSC) to Noah David, 

P.A. (hereinafter, Respondent) of 

Richmond, Virginia. Administrative 

Law Judge Exhibit (hereinafter, ALJX) 1 

(OSC), at 1. The OSC proposed the 

revocation of Respondent’s DEA 

Certificate of Registration No. 

MD3130717 (hereinafter, COR or 

registration) and the denial of ‘‘any 

pending application for renewal or 

modification of such registration and 

any applications for any other DEA 

registrations, pursuant to 21 U.S.C. 

824(a)(4), because [Respondent’s] 

registration is inconsistent with the 

public interest, as that term is defined 

in 21 U.S.C. 823(f).’’ Id. 

On April 7, 2020, the Respondent 

timely requested a hearing, which 

commenced (and ended) on September 

22, 2020, at the DEA Hearing Facility in 

Arlington, Virginia with the parties, 

counsel, and witnesses participating via 

video teleconference (VTC). On 

December 8, 2020, Chief Administrative 

Law Judge John J. Mulrooney, II 

(hereinafter, the Chief ALJ) issued his 

Recommended Rulings, Findings of 

Fact, Conclusions of Law and Decision 

of the Administrative Law Judge 

(hereinafter, Recommended Decision or 

RD). By letter dated January 5, 2021, the 

ALJ certified and transmitted the record 

to me for final Agency action. In that 

letter, the ALJ advised that neither party 

filed exceptions. Having reviewed the 

entire record, I adopt the ALJ’s rulings, 

findings of fact, as modified, 

conclusions of law and recommended 

sanction with minor modifications, 

where noted herein.*A

Recommended Rulings, Findings of 

Fact, Conclusions of Law, and Decision 

of the Administrative Law Judge 

John J. Mulrooney, II 

Chief Administrative Law Judge 

December 8, 2020 

*BAfter carefully considering the 

testimony elicited at the hearing, the 

admitted exhibits, the arguments of 

counsel, and the record as a whole, I 

have set forth my recommended 

findings of fact and conclusions of law 

below. 

I. Findings of Fact 

A. Allegations 

The Government alleges that the 

Respondent’s COR should be revoked 

because he has committed acts which 

render his continued registration against 

the public interest. ALJX 1, at 1. 

Specifically, the Government contends 

that on numerous occasions between 

April 2014 and November 2018, the 

Respondent unlawfully prescribed 

controlled substances to his wife 

without establishing a bona fide 

practitioner-patient relationship and 

without properly documenting 

treatment. Id. at 3–4. The Government 

additionally alleges that the Respondent 

conspired with colleagues to unlawfully 

receive controlled substances. Id. at 4. 

B. Stipulations 

The parties entered into a robust set 

of factual stipulations which were 

accepted by the tribunal. Accordingly, 

the following factual matters are 

deemed conclusively established in this 

case: 

1. The Respondent is registered with 

the DEA as a practitioner to handle 

controlled substances in Schedules II–V 

under DEA COR No. MD3130717 at 

5211 West Broad Street, Suite 101, 

Richmond, Virginia 23230–3000. 

2. DEA COR No. MD3130717 was 

issued on May 15, 2019 and expires by 

its own terms on June 30, 2022. 

3. The Respondent is presently 

licensed as a physician assistant in 

Virginia under License No. 0110004505, 

which expires April 30, 2021. 

4. Respondent Exhibit 1 is a true and 

correct copy of the Respondent’s COR. 

5. The Respondent prescribed the 

following controlled substances on the 

following dates to his wife, B.D.: 

(1) 11/28/2018: Oxycodone-Acetaminophen 

5–325, 36 tablets 

(2) 11/20/2018: Oxycodone-Acetaminophen 

5–325, 36 tablets 

(3) 11/08/2018: Oxycodone-Acetaminophen 

5–325, 36 tablets 

(4) [10/30/2018: Oxycodone-Acetaminophen 

5–325, 36 tablets] 

(5) 10/01/2018: Oxycodone-Acetaminophen 

10–325, 18 tablets 

(6) 9/21/2018: Oxycodone-Acetaminophen 

10–325, 18 tablets 

(7) 9/13/2018: Oxycodone-Acetaminophen 

10–325, 18 tablets 

(8) 9/06/2018: Oxycodone-Acetaminophen 5– 

325, 60 tablets 

(9) 8/22/2018: Oxycodone-Acetaminophen 5– 

325, 60 tablets 

(10) 8/17/2018: Oxycodone-Acetaminophen 

5–325, 60 tablets 

(11) 7/23/2018: Oxycodone-Acetaminophen 

5–325, 42 tablets 

(12) 7/10/2018: Oxycodone-Acetaminophen 

5–325, 84 tablets 

(13) 7/03/2018: Oxycodone-Acetaminophen 

10–325, 18 tablets 

(14) 5/30/2018: Acetaminophen-Codeine #3, 

60 tablets 

(15) 5/30/2018: Acetaminophen-Codeine #3, 

60 tablets (refill) 

(16) 5/30/2018: Acetaminophen-Codeine #3, 

60 tablets (refill) 

(17) 5/21/2018: Oxycodone-Acetaminophen 

5–325, 12 tablets 

(18) 5/08/2018: Diazepam 5mg, 30 tablets 

(19) 4/24/2018: Oxycodone-Acetaminophen 

10–325, 28 tablets 

(20) 3/16/2018: Oxycodone-Acetaminophen 

10–325, 28 tablets 

(21) 2/15/2018: Oxycodone-Acetaminophen 

10–325, 28 tablets 

(22) 2/09/2018: Oxycodone-Acetaminophen 

10–325, 12 tablets 

(23) 1/23/2018: Oxycodone-Acetaminophen 

10–325, 28 tablets 

(24) 1/19/2018: Oxycodone-Acetaminophen 

10–325, 12 tablets 

(25) 1/05/2018: Oxycodone-Acetaminophen 


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21166 Federal Register / Vol. 87, No. 69 / Monday, April 11, 2022 / Notices 

1The findings and recommendations in this 

Recommended Decision are restricted to the 

charged and preponderantly established 

misconduct. 

10–325, 42 tablets 

(26) 1/03/2018: Oxycodone-Acetaminophen 

10–325, 12 tablets 

(27) 12/22/2017: Oxycodone-Acetaminophen 

10–325, 42 tablets 

(28) 12/08/2017: Oxycodone-Acetaminophen 

10–325, 42 tablets 

(29) 11/21/2017: Oxycodone-Acetaminophen 

10–325, 42 tablets 

(30) 11/08/2017: Oxycodone-Acetaminophen 

10–325, 42 tablets 

(31) 10/25/2017: Oxycodone-Acetaminophen 

10–325, 42 tablets 

(32) 10/06/2017: Oxycodone-Acetaminophen 

10–325, 42 tablets 

(33) 9/22/2017: Oxycodone-Acetaminophen 

10–325, 42 tablets 

(34) 9/14/2017: Diazepam 5mg, 90 tablets 

(35) 8/28/2017: Oxycodone-Acetaminophen 

10–325, 56 tablets 

(36) 8/11/2017: Oxycodone-Acetaminophen 

10–325, 56 tablets 

(37) 7/27/2017: Oxycodone-Acetaminophen 

10–325, 56 tablets 

(38) 7/18/2017: Oxycodone-Acetaminophen 

10–325, 21 tablets 

(39) 7/06/2017: Oxycodone-Acetaminophen 

10–325, 28 tablets 

(40) 6/16/2017: Oxycodone-Acetaminophen 

10–325, 25 tablets 

(41) 6/05/2017: Oxycodone-Acetaminophen 

10–325, 28 tablets 

(42) 5/22/2017: Oxycodone-Acetaminophen 

10–325, 48 tablets 

(43) 5/08/2017: Lorazepam 2mg, 60 tablets 

(44) 4/06/2017: Oxycodone-Acetaminophen 

10–325, 48 tablets 

(45) 2/24/2017: Carisoprodol 250 mg, 90 

tablets 

(46) 2/24/2017: Diazepam 2mg, 90 tablets 

(47) 2/07/2017: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(48) 12/28/2016: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(49) 12/02/2016: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(50) 11/11/2016: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(51) 10/24/2016: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(52) 10/06/2016: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(53) 9/26/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(54) 9/14/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(55) 8/29/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(56) 8/16/2016: HydrocodoneAcetaminophen 10–325, 30 tablets 

(57) 7/21/2016: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(58) 6/24/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(59) 6/24/2016: Diazepam 2mg, 60 tablets 

(60) 6/10/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(61) 5/13/2016: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(62) 4/21/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(63) 3/25/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(64) 2/25/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(65) 2/05/2016: Oxycodone-Acetaminophen 

10–325, 30 tablets 

(66) 10/12/2015: Oxycodone-Acetaminophen 

10–325, 12 tablets 

(67) 10/09/2015: Oxycodone-Acetaminophen 

10–325, 12 tablets 

(68) 9/25/2015: Oxycodone-Acetaminophen 

10–325, 15 tablets 

(69) 5/29/2015: Oxycodone-Acetaminophen 

10–325, 60 tablets 

(70) 5/29/2015: Diazepam 5mg, 60 tablets 

(71) 4/05/2015: Oxycodone-Acetaminophen 

7.5–325, 60 tablets 

(72) 2/15/2015: Oxycodone-Acetaminophen 

7.5–325, 30 tablets 

(73) 12/21/2014: Oxycodone-Acetaminophen 

7.5–325, 30 tablets 

(74) 11/01/2014: Oxycodone-Acetaminophen 

7.5–325, 90 tablets 

(75) 9/11/2014: HydrocodoneAcetaminophen 7.5–325. 45 tablets 

(76) 7/24/2014: HydrocodoneAcetaminophen 7.5–325, 30 tablets 

(77) 6/04/2014: HydrocodoneAcetaminophen 7.5–325, 15 tablets 

(78) 4/15/2014: HydrocodoneAcetaminophen 7.5–325, 30 tablets 

6. The Respondent acted outside the 

usual course of professional practice in 

Virginia by issuing controlled substance 

prescriptions to his wife without 

establishing a bona fide practitionerpatient relationship and by failing to 

perform comprehensive examinations. 

7. The Respondent acted outside the 

usual course of professional practice in 

Virginia by issuing controlled substance 

prescriptions to his wife without 

properly documenting the treatment of 

his wife. 

8. The Respondent received 

prescriptions for controlled substances 

from L.K., P.A. on February 15, 2018, 

December 3, 2018, and December 4, 

2018. 

9. The Respondent received a 

prescription for a controlled substance 

from J.A., P.A., on September 14, 2018. 

10. Oxycodone is a Schedule II 

controlled substance pursuant to 21 CFR 

1308.12(b)(1)(xiv) and Va. Code Ann. 

§ 54.1–3448. 

11. Hydrocodone is a Schedule II 

controlled substance pursuant to 21 CFR 

1308.12(b)(1)(vi) and Va. Code Ann. 

§ 54.1–3448. 

12. On March 3, 2019, the Respondent 

completed the Professional Boundaries 

and Ethics Course—Extended Edition, a 

continuing medical education course 

conducted by the Professional 

Boundaries Institute (PBI). 

13. Respondent Exhibit 2 is a true and 

correct copy of the Respondent’s 

certificate of completion for the PBI 

Professional Boundaries and Ethics 

Course—Extended Edition continuing 

medical education course. 

14. The Respondent completed a PBI 

Maintenance and Accountability 

Seminars continuing medical education 

course of July 11, 2019. 

15. Respondent Exhibit 3 is a true and 

correct copy of the Respondent’s 

certificate of completion for the PBI 

Maintenance and Accountability 

Seminars continuing medical education 

course. 

16. The Respondent completed a VCU 

Health’s Safe Opiate Prescribing 

continuing medical education course on 

January 1, 2019. 

17. Respondent Exhibit 4 is a true and 

correct copy of the Respondent’s 

certificate of completion for VCU 

Health’s Safe Opiate Prescribing 

continuing medical education course. 

C. Government’s Case 

The Government’s case consisted of 

testimony from a diversion investigator 

assigned to the case that yielded these 

proceedings and a senior investigator 

from the Virginia Department of Health 

Professions. 

1. Diversion Investigator R.P. 

The Government presented the 

testimony of Diversion Investigator RP. 

(hereinafter, the DI). The DI testified 

that he has been a DI for approximately 

seven years and is currently stationed at 

the Richmond field office. Tr. 11–12. 

The DI’s testimony narrated the course 

of the investigation and authenticated a 

number of Government Exhibits. Id. at 

11–40. 

The DI testified that he worked with 

Task Force Officer C.E. (hereinafter, the 

TFO) in the investigation into the 

Respondent, a physician assistant (PA). 

Id. at 13–14. Their investigation began 

when the TFO was contacted by Senior 

Investigator K.L. at the Department of 

Health Professions (DHP). Id. at 13, 15. 

Senior Investigator K.L. informed DEA 

that during a DHP investigation of the 

Respondent, the Respondent admitted 

to ‘‘issuing prescriptions without 

legitimate use’’ to his wife, father-inlaw, a family friend, and a colleague’s 

spouse.1 Id. at 15. She then provided a 

copy of her investigative report to DEA. 

Id. at 15. 

In investigating the Respondent’s 

prescribing history, the DI generated a 

report from the Prescription Monitoring 

Program (PMP) regarding the 

Respondent’s prescribing. Id. at 16. The 

DI noted that the Respondent issued his 

first prescription to his wife 

approximately a month-and-a-half after 

he received his DEA COR. Id. at 16–17. 

The DI also accessed the PMP to 

generate a report relative to the 

controlled substance prescriptions that 


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2The BD PMP Report, which temporally included 

all controlled substance prescriptions written to her 

from January 1, 2014 to the date it was generated 

on December 18, 2018, was received into the record. 

GX 3. 

3The DI attempted to interview another PA, J.A., 

but learned that he was on vacation out of the 

country and the DI did not attempt to interview him 

when he returned. Id. at 31. 

4The DI testified that the interview took place at 

the U.S. Attorney’s Office and was attended by the 

TFO, an Assistant U.S. Attorney (AUSA), and a 

legal representative from RAR. Id. at 26–27. R.K. 

was not under arrest during the interview, forced 

to answer any questions, or offered anything in 

exchange for cooperating with the DI or the AUSA. 

Id. at 26–28. 

5The DI testified that the supervising physician 

was not forced to answer any questions, the 

interview took place at the U.S. Attorney’s Office, 

and was attended by the TFO, an AUSA, and a legal 

representative from RAR. Id. at 30–31. 

6The DHP SI explained that DHP is ‘‘the licensing 

and discipline entity for the Commonwealth of 

Virginia that licenses healthcare provider[s],’’ 

including physician assistants. Id. at 46–47. 

had been issued to Respondent’s wife.2

Id. at 17. The report revealed that over 

eighty-five prescriptions were written 

for her by the Respondent during the 

previous period of almost five years. Id. 

at 17. Seventy-two of those eighty-five 

prescriptions were for pain medications. 

Id. at 18. The DI testified that in 

analyzing the report, he perceived 

patterns wherein the Respondent, in the 

DI’s view, prescribed a high quantity of 

controlled substances for what the DI 

classified as a relatively short span of 

time. Id. at 18–19. The DI concluded 

that this pattern could support a 

possible indication of drug diversion. 

Id. The DI found it further curious that 

the controlled substance prescriptions 

that the Respondent wrote to his wife 

used both her maiden name and married 

name, so that, in the DI’s assessment of 

things, the Respondent ‘‘was actually 

issuing prescriptions to what appeared 

at face value to be two different 

individuals.’’ Id. at 20. 

In addition to a brief encounter with 

the Respondent, the DI interviewed 

three individuals: The pharmacist who 

filed the initial complaint with DHP; a 

PA coworker of the Respondent, R.K.; 

and a supervising physician at 

Radiology Associates of Richmond 

(RAR), the radiology practice where the 

Respondent was employed during the 

events that form the basis of this case.3

Id. at 23–31. 

The pharmacist told the DI that she 

noticed that the Respondent was 

receiving controlled substance 

prescriptions from colleagues, and that 

he was writing prescriptions to his wife 

under her married and maiden name. Id. 

at 23–24. During her interview with the 

DI, R.K. admitted that she issued several 

prescriptions to the Respondent without 

performing a medical exam or 

documenting the prescriptions and 

treatment.4 Id. at 25–26. Regarding one 

of the prescriptions, R.K. explained that 

she wrote the scrip because the 

Respondent had hurt his hand; ‘‘she 

could visibly see that it was affecting his 

procedures’’ but she ‘‘did not perform 

an examination, [and] she wrote a 

prescription based off of what she had 

observed from afar.’’ Id. at 28. The DI 

testified that R.K. told him that she 

issued prescriptions to the Respondent 

because ‘‘she trusted him. She trusted 

that he wasn’t taking advantage of her 

because he had . . . mentored her . . . 

when she first came into her profession’’ 

and ‘‘she didn’t think that he would ask 

her to do anything that was wrong or 

illegal.’’ Id. at 25–26. R.K. also related 

to the DI that as the Respondent 

continued to request more prescriptions, 

she became hesitant and progressively 

uncomfortable with writing him 

prescriptions, but continued to anyway. 

Id. at 28. 

During his interview, the supervising 

physician, who supervised the 

Respondent towards the end of the 

Respondent’s time at RAR, told the DI 

that the Respondent ‘‘received training 

on issuing legitimate prescriptions.’’ Id. 

at 29–30. According to the DI, the 

supervising physician also said that he 

‘‘had no reason to believe that [the 

Respondent] had misinterpreted what 

the regulations were when it comes to 

issuing prescriptions.’’ 5 Id. 

The DI presented as an objective 

regulator and investigator with no 

discernable motive to fabricate or 

exaggerate. The testimony of this 

witness was sufficiently detailed, 

plausible, and internally consistent to 

be afforded full credibility in this case. 

2. Senior Investigator K.L. 

The Government also presented 

testimony from DHP Senior Investigator 

K.L. (hereinafter, the DHP SI). The DHP 

SI testified that she has been a senior 

investigator with DHP 6 for eighteen 

years, a registered nurse for over thirty 

years, a master’s prepared registered 

nurse for over twenty-five years, and is 

currently stationed as an investigator in 

Henrico County. Id. at 44–45 and 48. 

The Respondent came to the attention 

of DHP when the previously-mentioned 

pharmacist filed a formal complaint on 

or around December 2018 and the DHP 

SI was assigned to conduct the 

investigation. Id. at 52–54 and 61–62. 

The DHP SI testified that during the 

course of her investigation, she obtained 

the Respondent’s PMP report, collected 

copies of relevant controlled substance 

scrips, and interviewed the previouslymentioned pharmacist, RAR employees, 

and the Respondent. Id. at 55. Around 

the end of January 2019, the DHP SI 

interviewed the Respondent and 

questioned him on the prescriptions he 

issued to his wife and the prescriptions 

written in his name by his PA 

colleagues, R.K. and J.A. Id. at 63–65. 

During the course of their conversation, 

the Respondent informed the DHP SI 

that some of the controlled substance 

prescriptions he received from his 

colleagues were to treat hand pain and 

cold congestion, but conceded that at no 

time did his PA colleagues perform any 

sort of assessment or exam. Id. at 65. 

According to the DHP SI, the PA 

colleagues confirmed that ‘‘they did not 

conduct any type of exam on [the 

Respondent] and [that] they did not 

document any of their assessments on 

him when they provided the 

prescriptions that he personally 

requested them to write.’’ Id. at 57. One 

of the medications that R.K. wrote for 

the Respondent was a combination of 

codeine and guaifenesin, which 

heightened the concern of the 

previously-mentioned pharmacist 

because the medication was not even 

dispensable as written. Id. at 66–67. J.A. 

told the DHP SI that the Respondent 

approached him for medication, 

supposedly to treat a migraine. Id. at 

69–70. J.A. related to the DHP SI that he 

knew the controlled substance the 

Respondent requested was not a typical 

treatment for migraines, and so decided 

that he would only prescribe a limited 

quantity of four pills. Id. at 70. 

The DHP SI’s investigation 

culminated in a report for the Virginia 

Board of Medicine that reflected that the 

Respondent wrote controlled substance 

prescriptions to his wife with no 

corroborating records, and that the 

Respondent received controlled 

substance prescriptions from his PA 

colleagues with no corroborating 

records. Id. at 67–68. 

Like the DI, the DHP SI presented as 

an objective regulator and investigator 

with no discernable motive to fabricate 

or exaggerate. The testimony of this 

witness was sufficiently detailed, 

plausible, and internally consistent to 

be afforded full credibility in this case. 

D. Respondent’s Case 

The Respondent’s affirmative case at 

the hearing consisted exclusively of his 

own testimony. The Respondent 

testified that he received his Bachelor of 

Arts degree in Biology from Lewis & 

Clark College in 2003, followed by a 

Master’s degree in Physician Assistant 

Studies from James Madison University 

in 2013. Tr. 87. He has been a licensed 

physician assistant in Virginia since 

2014. Id. at 90–91. After receiving his 


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7The Respondent testified that he worked at 

Alliance Physical Therapy for one year before he 

was furloughed in April 2020 due to the COVID– 

19 pandemic. Id. at 102, 104. He has since 

interviewed with Commonwealth Radiology, 

‘‘another radiologist/interventional radiology 

group,’’ and the Respondent testified that he was 

transparent with his potential future employers 

regarding the relevant investigations. Id. at 105. 

8The issue of why the Respondent, who is 

seeking to continue his status as a DEA registrant, 

needed to isolate himself from conducting the 

regulated activity he now seeks to preserve was 

never developed at the hearing. 

9No corroborating medical records or other 

documentation was offered by the Respondent in 

support of his wife’s purported medical issues. 

10The Respondent also admitted that he 

prescribed controlled substances to his wife while 

she was pregnant and that issuing such 

prescriptions while she was pregnant without 

proper supervision was potentially dangerous 

(although the wife’s obstetrician was aware of the 

narcotics she was taking). Id. at 152–54. 

11Again, the Respondent offered no form of 

corroboration for any of the medical conditions he 

ascribed to himself or his wife. 

license, the Respondent worked at the 

Center for Gastrointestinal Health in 

Petersburg, Virginia. Id. at 87–88, 94. At 

this first job the Respondent possessed 

the requisite authority to prescribe 

controlled substances, but by his 

recollection an occasion to do so never 

arose. Id. at 94–95. The Respondent 

testified that he left this job amicably in 

March 2015 in order to find another job 

that would provide family health 

benefits. Id. at 95. 

In March 2015, the Respondent began 

working for RAR in Richmond, Virginia, 

where he specialized in interventional 

radiology. Id. at 96. As a physician 

assistant at RAR, the Respondent 

exercised his COR authority to prescribe 

controlled substances. Id. at 97. 

Although RAR is a practice devoted to 

interventional radiology, he explained 

that the procedure-based nature of the 

practice did sometimes call for the 

prescribing of post-procedure controlled 

pain medications under established 

protocols. Id. at 98–99. The Respondent 

explained that at RAR, prescribing 

within the usual course of professional 

practice meant ‘‘[f]ollowing the 

protocols of the supervising physician.’’ 

Id. at 99–100. The protocols involved 

meeting with the supervising physician 

and acquiring from the physician a 

written treatment plan for each patient. 

Id. at 100. The Respondent also testified 

that in the course of prescribing a 

patient a controlled substance he would 

conduct an ‘‘extremely’’ comprehensive 

exam, including a full history and 

physical, and then ‘‘thoroughly’’ 

document the findings of the 

examinations. Id. at 100. Once he was 

notified of DHP’s investigation into him, 

the Respondent transparently notified 

his supervisors at RAR. Id. at 101. He 

was initially put on administrative 

leave, but then was afforded the option 

to resign from the practice, which he 

exercised in February 2019. Id. at 101. 

In April 2019, the Respondent 

secured employment at Alliance 

Physical Therapy, a physical therapy 

clinic.7 Id. at 102. The Respondent 

explained that Alliance Physical 

Therapy has a strong policy against 

prescribing controlled substances to 

patients, and that he ‘‘wanted that job 

because [he] knew that this was 

something that just [he] needed to not 

do. And [he] needed it not to be 

available.’’ 8 Id. at 102. However, in one 

instance, extenuating circumstances 

arose that required prescribing 

Tramadol to a patient, which the 

Respondent prescribed only after 

conferring with his supervising 

physician who then made the decision 

to prescribe a controlled substance. Id. 

at 103–04. 

In addressing the allegations brought 

by the Government, the Respondent 

admitted to improperly prescribing 

controlled substances to his wife and 

offered testimony to potentially help 

clarify the surrounding circumstances. 

In 2012, when the Respondent noticed 

that his wife (B.D.) had developed a 

severe limp after running, and upon his 

insistence, his wife consulted an 

orthopedist. Id. at 105. The orthopedist 

diagnosed B.D. with a CAM lesion on 

the head of her femur and subsequently 

performed surgery to reconstruct her hip 

and treat the CAM lesion. Id. at 105–07. 

According to the Respondent,9 after the 

surgery his wife experienced increased 

pain and developed arthritis, which was 

diagnosed by orthopedist Dr. J.H. Id. at 

107–09. Dr. J.H. treated B.D. with nonsteroidal anti-inflammatories (NSAIDs), 

but she developed an ulcer. Id. at 109– 

10. To address her pain, B.D. then took 

part in physical therapy, yoga, 

swimming, different types of NSAIDs, 

Tylenol, and then received injections. 

Id. at 110. The Respondent testified that 

injections helped with his wife’s 

symptoms, but not long-term. Id. at 110– 

11. In April 2014, after being treated by 

Dr. J.H. throughout, and not seeking care 

from another physician, B.D. was ‘‘at 

her wits’ end,’’ ‘‘was distraught,’’ ‘‘was 

in pain every day,’’ ‘‘was having a hard 

time just getting around the house,’’ 

‘‘things got desperate,’’ and she asked 

the Respondent for something to relieve 

her pain. Id. at 111–12. The Respondent 

wrote his wife a controlled substance 

prescription, but upon circumspection, 

if he ‘‘could go back, [he] certainly 

would not do it again.’’ Id. at 112. 

The Respondent openly admitted that 

the controlled substance prescriptions 

he wrote to his wife between April 2014 

and November 2018 were unlawful, 

unethical, unprofessional, wrong, and 

not valid, and that he even knew it was 

wrong at the time.10 Id. at 113–14. In 

explaining his logic behind writing 

prescriptions that were unlawful and 

wrong, the Respondent offered the 

following: 

I mean, it was really a matter of 

convenience. I saw her quality of life 

improve. And it just snowballed because of 

convenience. And through the years of doing 

it, my anxiety was—got worse and worse. I 

knew—I knew it was wrong. And it’s really 

just—it’s fortunate it didn’t hurt our 

relationship, but it made my life quite 

distraught. Id. at 114 (emphasis supplied). 

Counsel for the Respondent read 

through Allegations 8–11 from the OSC, 

asking for each whether the Respondent 

understood the allegation and whether 

the Respondent agreed with the 

allegation. Id. at 133–36. The 

Respondent testified that he understood 

and agreed with Allegations 8–11. Id. at 

133–36. 

The Respondent also admitted to 

improperly receiving controlled 

substance prescriptions from his PA 

colleagues. It is the Respondent’s 

recollection that he first approached 

R.K. for a controlled substance 

prescription after he underwent hand 

surgery and his treating surgeon denied 

him pain medication.11 Id. at 137–38. 

The Respondent explained that 

acquiring the prescription from R.K. was 

wrong and that he knew he was asking 

her to violate RAR’s protocols that 

required PAs to prescribe controlled 

substances under the guidance of a 

physician. Id. at 139–40. The 

Respondent also openly admitted that 

he agreed with the Government’s 

allegations that he did not have a bona 

fide practitioner-patient relationship 

with his PA colleagues, that they did 

not document the treatment they 

rendered to him, and that he received 

the controlled substance prescriptions 

from them outside the usual course of 

professional practice. Id. at 143–44. In 

his own words, the Respondent 

described his conduct in regards to 

receiving the relevant prescriptions 

from his PA colleagues as 

‘‘unprofessional.’’ Id. at 144–45. The 

Respondent testified that he took 

advantage of his colleagues because he 

knew he could not get the prescriptions 

he wanted from a doctor and that he 

knew his PA colleagues were not 

keeping medical records of his 

treatment because they could be 

disciplined for doing so. Id. at 151–52. 

Based on his PA colleagues’ conduct, 

the Respondent agreed that they both 


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12 Inexplicably, the opiate prescribing course 

certificate indicates that the course was conducted 

on ‘‘July 11, 2017–December 31, 2020.’’ RX 4. 

13 Indeed, no physician who treated his wife 

before or after his misconduct prescribed controlled 

substances for her. 

knew that their conduct in prescribing 

controlled substances to the Respondent 

was improper. Id. at 153. 

The Respondent testified that in the 

wake of the allegations against him, he 

took three continuing medical education 

(CME) courses to improve his practice. 

RX 2–4; Tr. 117–119, 127–28. He 

completed an in-person, thirty-four hour 

professional boundaries course on 

March 1 through March 3, 2019. RX 2; 

Tr. at 118. The Respondent testified that 

the course taught him about ‘‘getting in 

the habit of saying no’’ as foundational 

for operating within professional 

boundaries. Tr. at 118. The Respondent 

also testified that he participated in a 

twelve-week telephonic-contact course 

on maintenance and accountability that 

was completed on July 11, 2019 (Phone 

Follow-up Exercise). RX 3; Tr. at 122– 

23. The Phone Follow-up Exercise was 

an extension of the first and consistent 

of twelve one-hour weekly seminars 

conducted via telephone. Tr. at 122–23. 

The Respondent explained that the 

Phone Follow-up Exercise afforded him 

the opportunity to express the remorse, 

embarrassment, and anger he felt over 

his actions, as well as share the tools he 

was developing to maintain professional 

boundaries (including taking a position 

at a practice with a non-narcotic policy, 

refusing a prescription pad, and having 

a habit of saying no). Id. at 126–27. In 

addition to the professional boundaries 

course and the Phone Follow-up 

Exercise, the Respondent testified that 

he completed a two-hour online course 

in safe opiate prescribing through 

Virginia Commonwealth University’s 

medical school.12 RX 4; Tr. at 127–29. 

The Respondent also testified that 

moving forward, he intends to comply 

with all laws regarding controlled 

substances and that he ‘‘will only 

prescribe when appropriate and only to 

patients when it’s well documented and 

for an appropriate reason.’’ Tr. at 132. 

He acknowledged the severity of his 

repeated intentional acts, but also feels 

that this has only ever been a personal 

issue and that his misguidance has 

never lapsed over into affecting the 

public. Id. at 147–48. 

As is generally the case, the 

Respondent unarguably possesses the 

greatest interest in the outcome of these 

proceedings, and hence, the greatest 

motivation to enhance, modify, or even 

fabricate his testimony. While the 

Respondent’s testimony was generally 

consistent, it was not always free from 

confusing aspects. He stated and 

admitted that he issued controlled 

substances to his wife for years knowing 

that it was wrong, and explained that he 

understood that it was unlawful, 

unprofessional, and wrong, which is 

information that he undoubtedly 

possessed while the misconduct was 

underway. The Respondent presented as 

a knowledgeable professional who, at all 

times relevant, understood the rules, but 

yet engaged in an extended course of 

conduct that he knew was 

unprofessional, illegal, and dangerous.13

He even allowed that his actions caused 

him a considerable level of 

consternation. The Respondent’s 

testimony that he was aware of and 

adhered to detailed examination and 

prescribing protocols regarding RAR 

patients stands in no small measure of 

conflict with his extended level of 

unlawful prescribing, punctuated by the 

calculated practice of interchanging his 

wife’s maiden and married names. Odd 

also was the Respondent’s assertion that 

after the commencement of the DHP 

investigation he began working at a 

physical therapy clinic that has a strong 

policy against prescribing controlled 

substances to patients. He explained 

that he ‘‘wanted that job because [he] 

knew that this was something that just 

[he] needed to not do. And [he] needed 

it not to be available.’’ Tr. 102. The 

testimony is almost reminiscent of an 

addictive personality seeking to avoid 

the temptation of the focus of the 

addiction; and yet, the Respondent 

seeks to continue prescribing controlled 

substances. In an apparent 

abandonment of his prescribing 

avoidance, upon his COVID-related 

furlough, the Respondent is currently 

pursuing employment at 

Commonwealth Radiology, where, if 

successful, it appears his duties will 

mirror those at RAR, including his 

controlled substance prescribing 

responsibilities. It is not so much that 

the Respondent is incredible, he is not 

that. It is more that his presentation was 

confusing, and at times enigmatic. 

Other facts necessary for a disposition 

of this case are set forth in the balance 

of this Recommended Decision. 

II. Discussion 

A. Public Interest Determination: The 

Standard 

Under 21 U.S.C. 824(a)(4), the Agency 

may revoke the COR of a registrant if the 

registrant ‘‘has committed such acts as 

would render his registration . . . 

inconsistent with the public interest.’’ 

21 U.S.C. 824(a)(4). Congress has 

circumscribed the definition of public 

interest in this context by directing 

consideration of the following factors: 

(1) The recommendation of the appropriate 

State licensing board or professional 

disciplinary authority. 

(2) The [registrant’s] experience in 

dispensing, or conducting research with 

respect to controlled substances. 

(3) The [registrant’s] conviction record 

under Federal or State laws relating to the 

manufacture, distribution, or dispensing of 

controlled substances. 

(4) Compliance with applicable State, 

Federal, or local laws relating to controlled 

substances. 

(5) Such other conduct which may threaten 

the public health and safety. 21 U.S.C. 823(f). 

‘‘These factors are to be considered in 

the disjunctive.’’ Robert A. Leslie, M.D., 

68 FR 15227, 15230 (2003). Any one or 

a combination of factors may be relied 

upon, and when exercising authority as 

an impartial adjudicator, the Agency 

may properly give each factor whatever 

weight it deems appropriate in 

determining whether a registrant’s COR 

should be revoked. Id.; see Morall v. 

DEA, 412 F.3d 165, 173–74 (D.C. Cir. 

2005). Moreover, the Agency is ‘‘not 

required to make findings as to all of the 

factors,’’ Hoxie v. DEA, 419 F.3d 477, 

482 (6th Cir. 2005); Morall, 412 F.3d at 

173, and is not required to discuss 

consideration of each factor in equal 

detail, or even every factor in any given 

level of detail, Trawick v. DEA, 861 F.2d 

72, 76 (4th Cir. 1988) (holding that the 

Administrator’s obligation to explain 

the decision rationale may be satisfied 

even if only minimal consideration is 

given to the relevant factors, and that 

remand is required only when it is 

unclear whether the relevant factors 

were considered at all). The balancing of 

the public interest factors ‘‘is not a 

contest in which score is kept; the 

Agency is not required to mechanically 

count up the factors and determine how 

many favor the Government and how 

many favor the registrant. Rather, it is 

an inquiry which focuses on protecting 

the public interest . . . .’’ Jayam 

Krishna-Iyer, M.D., 74 FR 459, 462 

(2009). 

In adjudicating a revocation of a DEA 

COR, the DEA has the burden of proving 

that the requirements for the revocation 

it seeks are satisfied. 21 CFR 1301.44(e). 

Where the Government has met this 

burden by making a prima facie case for 

revocation of a registrant’s COR, the 

burden of production then shifts to the 

registrant to show that, given the totality 

of the facts and circumstances in the 

record, revoking the registrant’s COR 

would not be appropriate. Med. ShoppeJonesborough, 73 FR 364, 387 (2008). 

Further, ‘‘to rebut the Government’s 

prima facie case, [a registrant] is 


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14The Agency has repeatedly upheld this policy. 

See Ronald Lynch, M.D., 75 FR 78745, 78754 (2010) 

(holding that the respondent’s attempts to minimize 

misconduct undermined acceptance of 

responsibility); George Mathew, M.D., 75 FR 66138, 

66140, 66145, 66148 (2010); George C. Aycock, 

M.D., 74 FR 17529, 17543 (2009); Krishna-Iyer, 74 

FR at 463; Steven M. Abbadessa, D.O., 74 FR 10077, 

10078 (2009); Med. Shoppe-Jonesborough, 73 FR at 

387. 

15The record contains no recommendation from 

any state licensing board or professional 

disciplinary authority (Factor One), but, aside from 

cases establishing a complete lack of state authority, 

the presence or absence of such a recommendation 

has not historically been a case-dispositive issue 

under the Agency’s precedent. Patrick W. Stodola, 

M.D., 74 FR 20727, 20730 (2009); Krishna-Iyer, 74 

FR at 461. Similarly, there is no record evidence of 

a conviction record relating to regulated activity 

(Factor Three). Even apart from the fact that the 

plain language of this factor does not appear to 

emphasize the absence of such a conviction record, 

myriad considerations are factored into a decision 

to initiate, pursue, and dispose of criminal 

proceedings by federal, state, and local prosecution 

authorities which lessen the logical impact of the 

absence of such a record. See Robert L. Dougherty, 

M.D., 76 FR 16823, 16833 n.13 (2011); Dewey C. 

MacKay, M.D., 75 FR 49956, 49973 (2010) (‘‘[W]hile 

a history of criminal convictions for offenses 

involving the distribution or dispensing of 

controlled substances is a highly relevant 

consideration, there are any number of reasons why 

a registrant may not have been convicted of such 

an offense, and thus, the absence of such a 

conviction is of considerably less consequence in 

the public interest inquiry.’’), aff’d, MacKay v. DEA, 

664 F.3d 808 (10th Cir. 2011); Ladapo O. Shyngle, 

M.D., 74 FR 6056, 6057 n.2 (2009). Therefore, the 

absence of criminal convictions militates neither for 

nor against the revocation sought by the 

Government. Because the Government’s allegations 

and evidence fit squarely within the parameters of 

Factors Two and Four and do not raise ‘‘other 

conduct which may threaten the public health and 

safety,’’ 21 U.S.C. 823(f)(5), Factor Five militates 

neither for nor against the sanction sought by the 

Government in this case. 

*COmitted for brevity. 

required not only to accept 

responsibility for [the established] 

misconduct, but also to demonstrate 

what corrective measures [have been] 

undertaken to prevent the re-occurrence 

of similar acts.’’ Jeri Hassman, M.D., 75 

FR 8194, 8236 (2010); accord KrishnaIyer, 74 FR at 464 n.8. In determining 

whether and to what extent a sanction 

is appropriate, consideration must be 

given to both the egregiousness of the 

offense established by the Government’s 

evidence and the Agency’s interest in 

both specific and general deterrence. 

David A. Ruben, M.D., 78 FR 38363, 

38364, 38385 (2013). 

Normal hardships to the registrant, 

and even to the surrounding 

community, which are attendant upon 

lack of registration, are not a relevant 

consideration. See Linda Sue Cheek, 

M.D., 76 FR 66972, 66972–73 (2011); 

Gregory D. Owens, D.D.S., 74 FR 36751, 

36757 (2009). Further, the Agency’s 

conclusion that ‘‘past performance is the 

best predictor of future performance’’ 

has been sustained on review in the 

courts, Alra Labs., Inc. v. DEA, 54 F.3d 

450, 452 (7th Cir. 1995), as has the 

Agency’s consistent policy of strongly 

weighing whether a registrant who has 

committed acts inconsistent with the 

public interest has accepted 

responsibility and demonstrated that he 

or she will not engage in future 

misconduct. Hoxie, 419 F.3d at 483.14

Although the burden of proof at this 

administrative hearing is a 

preponderance-of-the-evidence 

standard, see Steadman v. SEC, 450 U.S. 

91, 100–03 (1981), the Agency’s 

ultimate factual findings will be 

sustained on review to the extent they 

are supported by ‘‘substantial 

evidence,’’ Hoxie, 419 F.3d at 481. 

While ‘‘the possibility of drawing two 

inconsistent conclusions from the 

evidence’’ does not limit the 

Administrator’s ability to find facts on 

either side of the contested issues in the 

case, Shatz v. U.S. Dep’t of Justice, 873 

F.2d 1089, 1092 (8th Cir. 1989) (internal 

citation omitted), all ‘‘important 

aspect[s] of the problem,’’ such as a 

respondent’s defense or explanation that 

runs counter to the Government’s 

evidence, must be considered, 

Wedgewood Vill. Pharmacy v. DEA, 509 

F.3d 541, 549 (D.C. Cir. 2007); see 

Humphreys v. DEA, 96 F.3d 658, 663 

(3d Cir. 1996). The ultimate disposition 

of the case ‘‘must be ‘in accordance 

with’ the weight of the evidence, not 

simply supported by enough evidence 

‘to justify, if the trial were to a jury, a 

refusal to direct a verdict when the 

conclusion sought to be drawn from it 

is one of fact for the jury.’ ’’ Steadman, 

450 U.S. at 99 (quoting Consolo v. FMC, 

303 U.S. 607, 620 (1966)). 

Regarding the exercise of 

discretionary authority, the courts have 

recognized that gross deviations from 

past agency precedent must be 

adequately supported, Morall, 412 F.3d 

at 183, but mere unevenness in 

application does not, standing alone, 

render a particular discretionary action 

unwarranted. Chein v. DEA, 533 F.3d 

828, 835 (D.C. Cir. 2008), cert. denied, 

555 U.S. 1139 (2009); cf. Dep’t of 

Homeland Security v. Regents of Univ. 

of Cal., 140 S. Ct. 1891, 1913 (2020) 

(holding that an agency must carefully 

justify significant departures from prior 

policy where reliance interests are 

implicated). It is well settled that, 

because the Administrative Law Judge 

has had the opportunity to observe the 

demeanor and conduct of hearing 

witnesses, the factual findings set forth 

in this Recommended Decision are 

entitled to significant deference, see 

Universal Camera Corp. v. NLRB, 340 

U.S. 474, 496 (1951), and that this 

Recommended Decision constitutes an 

important part of the record that must 

be considered in the Agency’s final 

decision, see Morall, 412 F.3d at 179. 

However, any recommendations set 

forth herein regarding the exercise of 

discretion are by no means binding on 

the Administrator and do not limit the 

exercise of that discretion. See 5 U.S.C. 

557(b); River Forest Pharmacy, Inc. v. 

DEA, 501 F.2d 1202, 1206 (7th Cir. 

1974); Attorney General’s Manual on the 

Administrative Procedure Act § 8(a) 

(1947). 

B. Factors Two and Four: The 

Respondent’s Experience Dispensing 

Controlled Substances and Compliance 

With Federal, State, and Local Law 

The Government has founded its 

theory for sanction exclusively on 

Public Interest Factors Two (the 

Respondent’s experience conducting 

regulated activity) and Four (the 

Respondent’s compliance with state and 

federal laws related to controlled 

substances), and it is under those two 

factors that the lion’s share of the 

evidence of record relates.15 In this case, 

the gravamen of the allegations in the 

OSC, as well as the factual 

concentration of much of the evidence 

presented, share as a principal focus the 

Respondent’s prescribing of controlled 

substances to his (non-patient) wife, and 

his role in receiving controlled 

substance prescriptions issued to him 

by his DEA registrant co-workers. The 

structure of the Government’s theory, 

and the Respondent’s case to meet that 

theory, renders it analytically logical to 

consider Public Interest Factors Two 

and Four together regarding the 

Respondent’s prescribing, and Factor 

Four independently with respect to the 

role the Respondent played in securing 

controlled substance prescriptions from 

his colleagues. That being said, Factors 

Two and Four involve analysis of both 

common and distinct considerations. 

Regarding Factor Two, the 

Respondent is a credentialed and 

experienced physician assistant who 

has been treating patients, in various 

capacities, for around six years. Tr. 90. 

Likewise, the evidence of record points 

to issues regarding controlled substance 

prescribing to his wife (B.D.) and 

himself; and there is no evidence of 

record that the Respondent has been the 

subject of discipline by state or federal 

authorities relative to his controlled 

substance prescribing to legitimate 

patients.*C While there is no evidence 

to contradict the Respondent’s 

contention that he has never let his 

prescribing deficiencies seep over into 

other aspects of his medical practice, 


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*DOmitted for brevity. 

the Agency has long found that benign 

experience cannot overcome intentional 

misconduct, and that the misconduct 

established by record evidence is 

considered under both Factors Two and 

Four. See Roberto Zayas, M.D., 82 FR 

21410, 21422 n.27 (2017) (announcing 

that ‘‘misconduct is misconduct 

whether it is relevant under Factor Two, 

Factor Four, or Factor Five, or multiple 

factors’’). It is beyond argument that 

every scrap of established misconduct 

in this case is of the intentional variety. 

Thus, the balance of the evidence 

related to Factor Two [ ]will be 

considered below together with Factor 

Four. 

As discussed, supra, Factor Four 

compels consideration of the 

Respondent’s compliance with state and 

federal laws related to controlled 

substances. The DEA regulations 

provide that to be effective, a 

prescription must be issued for a 

legitimate medical purpose by a 

practitioner acting in the usual course of 

professional practice. 21 CFR 

1306.04(a). The Supreme Court has 

opined that, ‘‘the prescription 

requirement . . . ensures patients use 

controlled substances under the 

supervision of a doctor so as to prevent 

addiction and recreational abuse.’’ 

Gonzales v. Oregon, 546 U.S. 243, 274 

(2006). Further, the Agency’s authority 

to revoke a registration is not limited to 

instances where a practitioner has 

intentionally diverted controlled 

substances. Bienvenido Tan, 76 FR 

17673, 17689 (2011); see Dewey C. 

MacKay, 75 FR at 49974 (holding that 

revocation is not precluded merely 

because the conduct was 

‘‘unintentional, innocent, or devoid of 

improper motive’’) (citation omitted). 

To effectuate the dual goals of 

conquering drug abuse and controlling 

both legitimate and illegitimate traffic in 

controlled substances, ‘‘Congress 

devised a closed regulatory system 

making it unlawful to manufacture, 

distribute, dispense, or possess any 

controlled substance except in a manner 

authorized by the [Controlled 

Substances Act (CSA)].’’ Gonzales v. 

Raich, 545 U.S. 1, 13 (2005). Consistent 

with the maintenance of that closed 

regulatory system, subject to limited 

exceptions not relevant here, a 

controlled substance may only be 

dispensed upon a prescription issued by 

a practitioner, and such a prescription is 

unlawful unless it is ‘‘issued for a 

legitimate medical purpose by an 

individual practitioner acting in the 

usual course of his professional 

practice.’’ 21 CFR 1306.04(a); see 21 

U.S.C. 829. Furthermore, ‘‘[a]n order 

purporting to be a prescription issued 

not in the usual course of professional 

treatment . . . is not a prescription 

within the meaning and intent of [21 

U.S.C. 829] and the person knowingly 

. . . issuing it, shall be subject to the 

penalties provided for violations of the 

provisions of law related to controlled 

substances.’’ 21 CFR 1306.04(a). 

The prescription requirement is 

designed to ensure that controlled 

substances are used under the 

supervision of a doctor, as a bulwark 

against the risk of addiction and 

recreational abuse. George C. Aycock, 

M.D., 74 FR 17529, 17541 (2009) (citing 

Gonzales, 546 U.S. at 274); see also 

United States v. Moore, 423 U.S. 122, 

135, 142–43 (1975) (noting that 

evidence established that a physician 

exceeded the bounds of professional 

practice when he gave inadequate 

examinations or none at all, ignored the 

results of the tests he did make, and 

took no precautions against misuse and 

diversion). The prescription 

requirement likewise stands as a 

proscription against doctors ‘‘peddling 

to patients who crave the drugs for those 

prohibited uses.’’ Gonzales, 546 U.S. at 

274. A registered practitioner is 

authorized to dispense, which the CSA 

defines as ‘‘to deliver a controlled 

substance to an ultimate user . . . by, or 

pursuant to the lawful order of a 

practitioner.’’ 21 U.S.C. 802(10); see also 

Rose Mary Jacinta Lewis, 72 FR 4035, 

4040 (2007). The courts have sustained 

criminal convictions based on the 

issuing of illegitimate prescriptions 

where physicians conducted no 

physical examinations or sham physical 

examinations. United States v. Alerre, 

430 F.3d 681, 690–91 (4th Cir. 2005), 

cert. denied, 574 U.S. 1113 (2006); 

United States v. Norris, 780 F.2d 1207, 

1209 (5th Cir. 1986). 

‘‘Under the CSA, it is fundamental 

that a practitioner must establish and 

maintain a [bona fide] doctor-patient 

relationship in order to act in the usual 

course of . . . professional practice and 

to issue a prescription for a legitimate 

medical purpose.’’ Dewey C. Mackay, 

M.D., 75 FR 49956, 49973 (2010) 

(citation omitted); Stodola, 74 FR at 

20731; Shyngle, 74 FR at 6057–58. The 

CSA generally looks to state law to 

determine whether a bona fide doctorpatient relationship was established and 

maintained. Stodola, 74 FR at 20731; 

Shyngle, 74 FR at 6058; Kamir GarcesMejias, M.D., 72 FR 54931, 54935 

(2007); United Prescription Servs., Inc., 

72 FR 50397, 50407 (2007). 

The CSA authorizes the ‘‘regulat[ion 

of] medical practice so far as it bars 

doctors from using their prescriptionwriting powers as a means to engage in 

illicit drug dealing and trafficking as 

conventionally understood,’’ Gonzales, 

546 U.S. at 909–10, and the Agency also 

evaluates cognizant state standards. 

Joseph Gaudio, M.D., 74 FR 10083, 

10090 (2009); Garces-Mejias, 72 FR at 

54935; United Prescription Services, 

Inc., 72 FR 50397, 50407 (2007).*D

Here, the relevant provisions of 

Virginia state law largely mirror the 

CSA and its regulations where they do 

not go beyond it. Compare Va. Code 

Ann. § 54.1–3303(C) with 21 CFR 

1304.06(a). The Virginia Code requires a 

bona fide patient-practitioner 

relationship to exist for the issuance of 

any prescriptions (controlled and noncontrolled) in the state. Va. Code Ann. 

§ 54.1–3303(B). The elements of a bona 

fide patient-practitioner relationship are 

spelled out in the code and require that 

the practitioner must have: 

(i) Obtained or caused to be obtained a 

medical or drug history of the patient; 

(ii) provided information to the patient 

about the benefits and risks of the drug being 

prescribed; 

(iii) performed or caused to be performed 

an appropriate examination of the patient, 

either physically or by the use of 

instrumentation and diagnostic equipment 

through which images and medical records 

may be transmitted electronically; and 

(iv) initiated additional interventions and 

follow-up care, if necessary, especially if a 

prescribed drug may have serious side 

effects. 

Id. 

Except in cases involving a medical 

emergency, the examination required 

pursuant to clause (iii) shall be 

performed by the practitioner 

prescribing the controlled substance, a 

practitioner who practices in the same 

group as the practitioner prescribing the 

controlled substance, or a consulting 

practitioner. Id. Further, all treatment, 

both with and without controlled 

substances, must be properly 

documented in order to fall within the 

standard of care as articulated by the 

state. Va. Admin. Code § 85–50–177 

(requiring ‘‘timely, accurate, legible and 

complete records’’). The Virginia Code 

also prohibits a practitioner from . . . 

prescrib[ing] a controlled substance to 

himself or a family member, other than 

Schedule VI as defined in § 54.1–3455 

of the Code of Virginia, unless the 

prescribing occurs in an emergency 

situation or in isolated settings where 

there is no other qualified practitioner 

available to the patient, or it is for a 

single episode of an acute illness 

through one prescribed course of 

medication. Va. Admin. Code § 85–50– 

176(B). This provision additionally 

specifies that when such treatment of 


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16 Va. Admin. Code § 54.1–2915(A)(8). 

17 Va. Admin. Code § 54.1–2951(A)(17). 

18 Va. Admin. Code § 54.1–2951(A)(18) (emphasis 

added). 

19Civil conspiracy in this context requires a more 

rigorous showing that two or more persons 

combined to accomplish, by some concerted action, 

some criminal or unlawful purpose or some lawful 

purpose or some lawful purpose by a criminal or 

unlawful means. Cf. Shirvinski v. United States 

Coast Guard, 673 F.3d 308, 320 (4th Cir. 2012). 

20 Va. Code Ann. § 54.1–2915(A)(18). [Although 

not directly on point, it appears that the Virginia 

Medical Board has applied cooperating with others 

broadly as the Chief ALJ suggests. See e.g., In re: 

Pankaj Merchia, M.D., Virginia Department of 

Health Professions, Board of Medicine, 2017 WL 

2537574 (2017) (affirmed, Pankaj Merchia v. 

Virginia Board of Medicine, Va. Ct. App. 2018 WL 

6313710 (2018) (not reported) (sustaining Board’s 

finding under Va. Code Ann. § 54.1–2915(A)(18)) 

holding a practitioner responsible for not releasing 

patients’ medical records even though he was not 

in charge of the recordkeeping functions.)] 

*EAlthough I agree with the Chief ALJ that 

substantial evidence supports these violations, and 

I note that Respondent did not take exception to his 

finding, the facts on the record regarding 

Respondent’s unlawful prescribing to his wife over 

the course of several years alone offer more than 

enough support for my ultimate conclusion that 

Respondent’s registration is inconsistent with the 

public interest. 

21Stips. 1, 2, 3. 

22See 21 CFR 1301.44(e). 

self or family does occur, it must be 

properly documented to demonstrate 

compliance with the criteria for a bona 

fide patient-practitioner relationship. 

Va. Admin. Code § 85–50–176(C). 

Further, the Virginia Administrative 

Code cites twenty-four separate 

categories of unprofessional conduct 

that can result in disciplinary action. 

Va. Admin. Code § 54.1–2915. Within 

these myriad categories, the state has 

prohibited: ‘‘[p]rescribing or dispensing 

any controlled substance with intent or 

knowledge that it will be used otherwise 

than medicinally, . . . or with intent to 

evade any law with respect to the sale, 

use, or disposition of such drug;’’ 16

violating any state or federal law 

‘‘relating to the manufacture, 

distribution, dispensing, or 

administration of drugs;’’ 17 and 

‘‘[v]iolating or cooperating with others 

in violating any of the provisions of 

Chapters 1 (§ 54.1–100 et seq.), 24 

(§ 54.1–2400 et seq.) and this chapter 

[(§ 54.1–2900 et seq.)] or regulations of 

the Board.’’ 18 ‘‘Cooperating’’ is not 

defined in the Virginia Administrative 

Code, but by consciously electing to 

eschew the term ‘‘conspiracy,’’ 19 it is 

logical to assume that Virginia seeks a 

broader sweep of conduct that is easier 

to establish. 

In this case, the Respondent 

stipulated that he ‘‘acted outside the 

usual course of professional practice in 

Virginia by issuing controlled substance 

prescriptions to his wife (B.D.) without 

establishing a bona fide practitionerpatient relationship[,] by failing to 

perform comprehensive examinations[, 

and] without properly documenting the 

treatment of his wife (B.D.).’’ Stips 6, 7. 

Further, during the hearing, the 

Respondent stated that he understood 

and agreed with Allegations 8–11. Tr. 

133–36. Accordingly, OSC Allegations 4 

and 8–11 are sustained. 

Regarding the controlled substance 

prescriptions issued to the Respondent 

by his PA colleagues, the parties 

stipulated that the Respondent received 

controlled substance prescriptions from 

his PA colleagues on every date alleged 

in the OSC. Stips 8, 9. The 

Government’s theory, in essence, is that 

by importuning his PA colleagues to 

write controlled substance prescriptions 

for his personal use, without routing the 

matter through the physicians who 

supervise those PA practitioners, the 

evidence sustains the gentle standard of 

‘‘cooperating with others’’ 20 to facilitate 

their violation of the aforementioned 

state and federal laws relating to the 

dispensing of drugs. This aspect of the 

Government’s theory here is enhanced 

by the highly-regulated nature of 

controlled substance prescribing and the 

Respondent’s status as a COR holder/PA 

in the same office as his PA colleagues. 

The Respondent’s awareness of standard 

office practices and his fellow PAs, 

coupled with his experience, equipped 

him with the knowledge of how a direct 

request to his colleagues would likely be 

received and acted upon by his PA 

colleagues. The Respondent freely 

acknowledged during the hearing that 

he did not have a bona fide practitionerpatient relationship as a patient of his 

PA colleagues, that they did not 

document the treatment they rendered 

to him, and that he received the 

controlled substance prescriptions from 

them outside the usual course of 

professional practice. Tr. 143–44. 

Respondent’s PA colleagues also told 

investigators that they issued the 

prescriptions to the Respondent without 

performing a medical exam or 

documenting the prescriptions and 

treatment. Id. at 25–26, 57. Notably, the 

Respondent admitted that he took 

advantage of his PA colleagues because 

he knew he could get the scrips he 

wanted and that they would not 

document the treatment when he asked 

them for the scrips. Id. at 151–52. He 

described his own conduct in this 

regard as ‘‘unprofessional.’’ Id. at 144– 

45. Further, in his closing brief, the 

Respondent stated that he 

‘‘unequivocally accept[s] responsibility’’ 

for the ‘‘soliciting of controlled 

substance treatment from colleagues’’ 

and for ‘‘the misconduct and 

wrongfulness of his actions relative to 

the Government’s allegations relating to 

[his] conspiracy with his colleagues.’’ 

ALJX 15 at 7. Accordingly, OSC 

Allegations 5 and 12–14 are 

sustained.*E

Inasmuch as the Respondent’s state 

licensure and COR status are the subject 

of factual stipulations,21 OSC 

Allegations 1 and 2 are also sustained. 

Thus, a balancing of Factors Two and 

Four militate strongly in favor of the 

imposition of the revocation sanction 

sought by the Government. 

III. Sanction 

The evidence of record 

preponderantly establishes that the 

Respondent has committed acts which 

render his continued registration 

inconsistent with the public interest. 

See 21 U.S.C. 824(a)(4). Since the 

Government has met its burden 22 in 

demonstrating that the revocation it 

seeks is authorized, to avoid sanction, it 

becomes incumbent upon the 

Respondent to demonstrate that given 

the totality of the facts and 

circumstances revocation is not 

warranted. See Med. ShoppeJonesborough, 73 FR at 387. That is, 

upon the preponderant establishment of 

the Government’s prima facie case, the 

burden shifts to the Respondent to show 

why he should continue to be entrusted 

with a DEA registration. See Kaniz F. 

Khan-Jaffery, M.D., 85 FR 45667, 45689 

(2020); Garrett Howard Smith, M.D., 83 

FR 18882, 18910 (2018). Although by no 

means the only requirement, in order to 

rebut the Government’s prima facie 

case, the Respondent must demonstrate 

not only an unequivocal acceptance of 

responsibility but also a demonstrable 

plan of action to avoid similar conduct 

in the future. See Hassman, 75 FR at 

8236. While those two elements are key, 

the focus is, and must always be, rooted 

in a determination as to whether the 

Agency can have confidence that the 

Respondent can continue to be 

entrusted with the weighty and 

dangerous responsibilities of a 

registrant. Cf., Khan-Jaffery, M.D., 85 FR 

at 45689; Smith, M.D., 83 FR at 18910. 

While analytical frameworks applied to 

prior Agency actions provide useful 

guidance and helpful structure, such 

tools cannot distract the Agency from its 

critical mission to keep the public safe 

by only issuing and maintaining CORs 

in cases where the public is adequately 

protected. 

Agency decisions are clear that a 

respondent must ‘‘unequivocally admit 

fault’’ as opposed to a ‘‘generalized 


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23ALJX 15. 

*F I agree with the Chief ALJ that Respondent 

generally accepted responsibility, did not make 

excuses, pass blame or mitigate his misconduct— 

other than perhaps in his self-portrayal as merely 

someone who has trouble saying ‘‘no.’’ See infra 

III.B. It is noted that prior Agency decisions have 

made it clear that in order to avoid sanction once 

the Government has established a prima facie case, 

a registrant must do more than say the right thing 

on the stand and in filings. ‘‘The degree of 

acceptance of responsibility that is required does 

not hinge on the respondent uttering ‘‘magic 

words’’ of repentance, but rather on whether the 

respondent has credibly and candidly demonstrated 

that he will not repeat the same behavior and 

endanger the public in a manner that instills 

confidence in the Administrator.’’ Jeffrey Stein, 

M.D., 84 FR 46968, 49973 (2019). 

*G Further, I note that these courses were 

specifically marked with American Medical 

Association (AMA) credits, which as Respondent 

admitted were ‘‘the type of credits we all need for 

continuing education.’’ Tr. 121. Although the 

subject matter of the courses is certainly relevant to 

Respondent’s compliance with the CSA, and in 

particular, relevant to correcting his misconduct, I 

do not find significant value to the important 

question of whether he can be entrusted with a CSA 

registration in remedial measures that meet 

continuing education requirements. The record did 

not expand on whether he had used these credits 

for that purpose. If he had, that would certainly 

weigh against my consideration of them as remedial 

measures in this action. However, even if he did not 

use them for this dual purpose, I agree with the 

Chief ALJ that the remedial plan that Respondent 

offered was not adequate to ensure that I can entrust 

him with a registration. 

acceptance of responsibility.’’ The 

Medicine Shoppe, 79 FR 59504, 59510 

(2014); see also Lon F. Alexander, M.D., 

82 FR 49704, 49728 (2017). To satisfy 

this burden, the respondent must ‘‘show 

true remorse’’ or an ‘‘acknowledgment 

of wrongdoing.’’ Leslie, 68 FR at 15528. 

The Agency has made it clear that 

unequivocal acceptance of 

responsibility is paramount for avoiding 

a sanction. Robert L. Dougherty, M.D., 

76 FR 16823, 16834 (2011) (citing 

Krishna-Iyer, 74 FR at 464). This feature 

of the Agency’s interpretation of its 

statutory mandate on the exercise of its 

discretionary function under the CSA 

has been sustained on review. Jones 

Total Health Care Pharmacy, LLC v. 

DEA, 881 F.3d 823, 830–31 (11th Cir. 

2018); MacKay v. DEA, 664 F.3d 808, 

822 (10th Cir. 2011); Hoxie, 419 F.3d at 

483. 

A. Acceptance of Responsibility 

On the issue of acceptance, although 

(as discussed, supra) the Respondent’s 

testimony carried with it an 

intermittently confusing quality, it 

could not be fairly said that, taken as a 

whole (to include, at least to some 

extent, the attorney-authorized 

admissions in his closing brief) 23 that 

the Respondent did not accept 

responsibility. He did.*F

Regarding the required demonstration 

of remedial measures aimed at the 

avoidance of recurrence, the 

Respondent (predictably) promised that 

he would foreswear prescribing to his 

wife, friends, and relatives, and would 

presumably no longer seek to importune 

colleagues to authorize the dispensing 

of powerful drugs for his personal use. 

Additionally, the Respondent 

completed a three-day professional 

boundaries course, participated in the 

Phone Follow-up Exercise, and took an 

opiate prescribing course. RX 2–4.*G A 

fundamental issue here is not so much 

that the Respondent did not make a 

remedial plan of sorts, the issue is that 

the record demonstrates no information 

that the Respondent learned in the 

courses what he admittedly did not 

know while he was committing the 

misconduct. That is to say, he required 

no course to provide him with the 

revelation that writing prescriptions for 

powerful pain medications to his nonpatient wife was a breach of his state 

and federal obligations. It was obvious 

that he knew this was the case by the 

deceitful practices he employed in 

alternating between his wife’s maiden 

and married names. He admitted that 

the entire enterprise was causing him 

consternation, and yet he persevered in 

this unprofessional debacle for fourand-a-half years. Likewise, he did not 

suddenly gain understanding that 

having his PA colleagues (one of whom 

he was mentoring) prescribe controlled 

substances for him was beyond the pale. 

The Respondent understood every one 

of these lessons at the outset of the 

story. No moment of sudden realization 

and enlightenment was borne of two 

courses and a Phone Follow-up 

Exercise. The problem is that the 

Respondent is as aware of his 

obligations now as he was when his 

professional life spiraled out of control. 

A registrant who gains specialized 

knowledge in the intricacies of 

documentation from coursework, or 

incorporates process changes in his/her 

practice to address a diversion risk are 

examples of scenarios where a remedial 

plan can carry significant influence. On 

this record, where the Respondent knew 

what to do during every moment of the 

period in question, the weight that can 

logically be attached to his remedial 

steps must be significantly diminished. 

Stated differently, he knew then and he 

knows now, and the ‘‘remedial plan’’ 

offered here is essentially an exercise in 

going through the motions. 

B. Specific and General Deterrence 

The issue here is appropriately 

resolved in the remaining guideposts of 

the Agency’s analytical framework. In 

determining whether and to what extent 

imposing a sanction is appropriate, 

consideration must be given to the 

Agency’s interest in both specific and 

general deterrence and the 

egregiousness of the offenses established 

by the Government’s evidence. Ruben, 

78 FR at 38364, 38385. Each of these 

concepts bears separate consideration 

here. It is reasonable to conclude that, 

at least for the present, the Respondent 

is unlikely to re-commit these specific 

transgressions. His wife is being treated 

by a qualified physician (who is not 

prescribing controlled substances), and 

his former coworkers presumably know 

enough now not to trust him in the 

future. Thus, the issue of specific 

deterrence does not particularly favor 

the imposition of a sanction here. [The 

Chief ALJ found that specific deterrence 

does not particularly favor the 

imposition of a sanction here. Although 

I agree that Respondent might not be 

able to repeat the exact same behavior 

he conducted, I am not convinced by his 

remedial measures or the minimal 

consequences that he has faced thus far 

that he will not repeat similar behavior 

in mishandling his registration for 

personal gain. There is ample evidence 

on the record that Respondent knew 

what he was doing was unlawful. He 

admits as much. As discussed herein, he 

repeated the misconduct in prescribing 

controlled substances to his wife for 

several years, and made efforts to hide 

his behavior. He preyed on his colleague 

whom he had mentored—taking 

advantage of the imbalance of power in 

their relationship in order to obtain 

controlled substances when his own 

doctor had denied them. When 

Respondent proclaimed that he ‘‘is not 

the yes guy anymore,’’ Tr. 126, due to 

his apparently-enlightening ethics class, 

he implied that his misbehavior was 

linked to a lack of boundaries due to his 

over-accommodating personality, and 

he urged me to believe that suddenly he 

has re-established those boundaries— 

that he has broken ‘‘the habit and 

create[d] new habits to be able to 

perform within professional 

boundaries.’’ Tr. 118. However, contrary 

to this favorable self-portrayal, the 

egregious behavior on the record 

demonstrates more artful and 

intentional deceit than simply refusing 

to say no. All of the misconduct herein 

occurred after practitioners acting in the 

course of their professional practice had 

refused to prescribe controlled 

substances. See Tr. 138. Further, 

Respondent covered his tracks and 

manipulated relationships. As 

sympathetic as Respondent would make 

the situation sound—that he ‘‘wanted to 

help [his wife],’’ who was in pain, Tr. 


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142—the fact is that he repeatedly 

demonstrated behavior that is 

untrustworthy. I am not convinced that 

the few days of training that he took in 

ethics was so impactful as to have 

reformed him in the manner that he 

suggests. Therefore, I find that the issue 

of specific deterrence weighs in favor of 

revocation. 

Regarding general deterrence,] as the 

regulator in this field, the Agency bears 

the responsibility to deter similar 

misconduct on the part of others for the 

protection of the public at large. Ruben, 

78 FR at 38385. To the extent that no 

sanction is imposed, the unambiguous 

message to the regulated community 

would be that four-and-a-half years of 

enabling the (apparently inappropriate) 

use of powerful controlled drugs for a 

spouse, while employing the artifice of 

alternating scrip names, and only 

stopping when state and federal 

regulatory authorities are tipped off by 

a pharmacist, carries with it no 

consequence. The Respondent’s case in 

this regard might have been somewhat 

fortified if the level of cunning or the 

duration of the malfeasance had been 

more constrained, but the record is what 

it is. 

C. Egregiousness 

Considerations of egregiousness 

likewise support revocation. The 

Respondent carried on prescribing for 

his wife (even during her pregnancy) for 

four-and-a-half years, which is a 

significant amount of time to carry on 

with conduct that a person knows is 

straight-up wrong. The prescribing was 

not a one-off, an act of momentary 

desperation, or a misguided accident 

borne of professional ignorance, and 

there was no eureka moment. Like 

pressing his advantage with the PA 

colleague he mentored, the 

Respondent’s acts were consistently 

intentional. The intentional nature of 

the Respondent’s acts undermines the 

ability of the Agency, at least at present, 

to have confidence that he will 

responsibly exercise the responsibilities 

of a DEA registrant. 

Accordingly, it is respectfully 

recommended that the Respondent’s 

DEA COR should be revoked, and any 

pending applications for renewal should 

be denied. 

Dated: December 8, 2020. 

John J. Mulrooney, II, 

Chief Administrative Law Judge. 

Order 

Pursuant to 28 CFR 0.100(b) and the 

authority vested in me by 21 U.S.C. 

824(a)(4) and 21 U.S.C. 823(f), I hereby 

revoke DEA Certificate of Registration 

No. MD3130717 issued to Noah David, 

P.A. Further, pursuant to 28 CFR 

0.100(b) and the authority vested in me 

by 21 U.S.C. 824(a) and 21 U.S.C. 823(f), 

I hereby deny any pending application 

of Noah David, P.A. to renew or modify 

this registration, as well as any other 

pending application of Noah David, P.A. 

for registration in Virginia. This Order is 

effective May 11, 2022. 

Anne Milgram, 

Administrator. 

[FR Doc. 2022–07688 Filed 4–8–22; 8:45 am] 

BILLING CODE 4410–09–P 

DEPARTMENT OF JUSTICE 

Drug Enforcement Administration 

Douglas A. Blose, M.D.; Decision and 

Order 

On September 28, 2021, a former 

Acting Assistant Administrator, 

Diversion Control Division, Drug 

Enforcement Administration 

(hereinafter, Government), issued an 

Order to Show Cause (hereinafter, OSC) 

to Douglas A. Blose, M.D. (hereinafter, 

Registrant) of Downey, California. OSC, 

at 1 and 3. The OSC proposed the 

revocation of Registrant’s Certificate of 

Registration No. AB2619510. Id. at 1. It 

alleged that Registrant ‘‘[does not] have 

authority to dispense or prescribe 

controlled substances in the State of 

California, the state in which [he is] 

registered with the DEA.’’ Id. (citing 21 

U.S.C. 824(a)(3)). 

Specifically, the OSC alleged that on 

or about March 9, 2020, Registrant 

executed a Stipulated Surrender of 

License and Disciplinary Order, 

pursuant to which he surrendered his 

California medical license. Id. at 2. 

According to the OSC, Registrant’s 

surrender was accepted by the Medical 

Board of California on or about March 

30, 2020, and took effect on April 29, 

2020. Id. 

The OSC notified Registrant of the 

right to request a hearing on the 

allegations or to submit a written 

statement, while waiving the right to a 

hearing, the procedures for electing each 

option, and the consequences for failing 

to elect either option. Id. at 2–3 (citing 

21 CFR 1301.43). The OSC also notified 

Registrant of the opportunity to submit 

a corrective action plan. Id. at 3 (citing 

21 U.S.C. 824(c)(2)(C)). 

Adequacy of Service 

In a Declaration dated January 3, 

2022, a Diversion Investigator 

(hereinafter, DI) assigned to the Los 

Angeles Field Division stated that on or 

about September 29, 2021, she sent a 

copy of the OSC by certified mail to 

Registrant’s registered address. Request 

for Final Agency Action (hereinafter, 

RFAA), Exhibit (hereinafter, RFAAX) B 

(DI’s Declaration), at 1–3. The DI stated 

that according to USPS tracking 

information, the copy of the OSC was 

delivered on or about October 1, 2021. 

Id. at 2. The DI also stated that on or 

about October 21, 2021, she mailed a 

copy of the OSC to Registrant’s 

residential address as reflected on his 

California driver’s license. Id. The DI 

stated that according to USPS tracking 

information, the second copy of the OSC 

was delivered on or about October 23, 

2021. Id. The DI concluded that neither 

copy of the OSC was returned as 

undeliverable and that she has not 

received any communications from 

Registrant or anyone acting on 

Registrant’s behalf regarding the OSC. 

Id. 

The Government forwarded its RFAA, 

along with the evidentiary record, to 

this office on January 26, 2022. In its 

RFAA, the Government represents that 

more than thirty days have passed since 

Registrant was served with the OSC and 

Registrant has not requested a hearing 

nor otherwise corresponded with DEA 

regarding the OSC. RFAA, at 2. The 

Government requests that Registrant’s 

DEA registration be revoked based on 

his lack of authority to handle 

controlled substances in California, the 

state in which he is registered with the 

DEA. Id. at 6. 

Based on the DI’s Declaration, the 

Government’s written representations, 

and my review of the record, I find that 

the Government accomplished service 

of the OSC on Registrant on or before 

October 23, 2021. I also find that more 

than thirty days have now passed since 

the Government accomplished service 

of the OSC. Further, based on the DI’s 

Declaration, the Government’s written 

representations, and my review of the 

record, I find that neither Registrant, nor 

anyone purporting to represent 

Registrant, has requested a hearing, 

submitted a written statement while 

waiving Registrant’s right to a hearing, 

or submitted a corrective action plan. 

Accordingly, I find that Registrant has 

waived his right to a hearing and his 

right to submit a written statement or 

corrective action plan. 21 CFR 

1301.43(d) and 21 U.S.C. 824(c)(2)(C). I, 

therefore, issue this Decision and Order 

based on the record submitted by the 

Government, which constitutes the 

entire record before me. 21 CFR 

1301.43(e). 


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