Court Opinion

ID: 9394794
Source: CourtListenerOpinion
Date Created: 2023-05-16 15:03:59.268465+00
Date Added: 2024-06-11T17:19:03.017634
License: Public Domain

2023 IL App (3d) 220095

                                  Opinion filed May 16, 2023
      ____________________________________________________________________________

                                                   IN THE

                                    APPELLATE COURT OF ILLINOIS

                                             THIRD DISTRICT

                                                    2023

      BHANOO SHARMA, M.D.,                   )     Appeal from the Circuit Court
                                             )     of the 12th Judicial Circuit,
             Plaintiff-Appellant,            )     Will County, Illinois,
                                             )
             v.                              )
                                             )
      THE DIVISION OF PROFESSIONAL           )     Appeal No. 3-22-0095
      REGULATION OF THE                      )     Circuit No. 21-MR-2585
      DEPARTMENT OF FINANCIAL AND            )
      PROFESSIONAL REGULATION and            )
      CECILIA ABUNDIS, in Her Capacity as    )
      Acting Director of the Division of     )
      Professional Regulation,               )     Honorable
                                             )     John C. Anderson,
             Defendants-Appellees.           )     Judge, Presiding.
      ___________________________________________________________________________

           PRESIDING JUSTICE HOLDRIDGE delivered the judgment of the court, with opinion.
           Justices Albrecht and Davenport concurred in the judgment and opinion.
      ____________________________________________________________________________

                                                OPINION

¶1          The Illinois Department of Financial and Professional Regulation (Department), by its

     acting director of professional regulation, Cecilia Abundis (Director), indefinitely suspended Dr.

     Bhanoo Sharma’s Illinois medical license for a minimum of 18 months. Dr. Sharma sought review

     before the circuit court, which affirmed. Dr. Sharma appeals.
¶2                                           I. BACKGROUND

¶3          On February 19, 2021, the Department filed a petition for temporary suspension of Dr.

     Sharma’s Illinois medical license and a complaint citing section 22(A)(12) of the Medical Practice

     Act of 1987 (Act) (225 ILCS 60/22(A)(12) (West 2020)). Section 22 of the Act provides that the

     Department may take disciplinary action against a medical license when there has been “[a]dverse

     action taken by another state or jurisdiction against a license or other authorization to practice as

     a medical doctor.” Id. This is commonly referred to as sister-state discipline.

¶4          The Department’s filings set forth the following allegations. In August 2020, the Oregon

     Medical Board filed a complaint against Dr. Sharma’s Oregon medical license after it reviewed

     his care of four patients in his Illinois-based practice. The Oregon Medical Board opened its

     investigation after receiving a report that a $900,000 malpractice settlement against Dr. Sharma

     was paid in 2019 due to the death of a patient following a 2016 lipoplasty procedure. The Oregon

     Medical Board found that Dr. Sharma (1) was grossly negligent in performing liposuction and

     autologous fat transfers, (2) engaged in a pattern of conduct that breached the standard of care and

     constituted gross negligence, (3) subjected his patients to large volume liposuction without

     aftercare, fluid resuscitation, or monitoring afterwards, (4) responded to adverse events (such as

     cardiac arrest, syncope/diaphoresis, suspected allergic reaction, and hypertension) inadequately

     and dangerously, and (5) accepted patients for surgery who had contraindications to liposuction.

     In January 2021, the Oregon Medical Board entered a stipulated order wherein Dr. Sharma

     surrendered his Oregon medical license without admitting or denying the allegations. The order

     provided that the agreement was public record and the disciplinary action was reportable.

¶5          The Department’s filings also included Dr. Sharma’s licensing history. In 2012, the Oregon

     Medical Board opened an investigation, after receiving a complaint that a patient of Dr. Sharma’s

                                                      2
     died three days after undergoing a liposuction procedure in Oregon. In January 2015, the Oregon

     Medical Board concluded that Dr. Sharma engaged in conduct that was unprofessional or

     dishonorable as well as gross or repeated acts of negligence. The order provided, among other

     things, that Dr. Sharma was reprimanded, he was ordered to pay a civil penalty of $10,000 and

     complete education courses, and his Oregon medical license was revoked (which was stayed). In

     June 2015, the Department entered a consent order and Dr. Sharma’s Illinois license was

     reprimanded. The status of his Oregon license changed to inactive in March 2016 and lapsed in

     January 2018.

¶6          The Department included an affidavit of Dr. John Zander, M.D., the Deputy Medical

     Coordinator of the Department’s division of professional regulation. Dr. Zander stated that he

     reviewed the Oregon investigation, which revealed that Dr. Sharma’s care was grossly negligent,

     and he was aware Dr. Sharma surrendered his Oregon medical license. Dr. Zander appeared before

     the Director in an ex parte hearing and testified under oath that he believed Dr. Sharma presented

     a clear and present danger to the public in Illinois. He opined that Dr. Sharma’s conduct, which

     consisted of performing large-volume treatments in a single-person ambulatory center with a non-

     board certified anesthesiologist, was reckless and a “recipe for disaster and did end in disaster.”

     The Director found that the public interest, safety, and welfare imperatively required emergency

     action to prevent Dr. Sharma’s practice in that Dr. Sharma’s actions constituted an immediate

     danger to the public. The Director temporarily suspended Dr. Sharma’s Illinois license, pending a

     hearing on the complaint, which was scheduled in 11 days.

¶7          Dr. Sharma filed a motion to limit the hearing’s purpose to first ascertain the validity of

     the temporary suspension. The Department responded that there was no legal basis entitling him

     to a hearing on the temporary suspension, and he could ask for a continuance if he needed extra

                                                     3
       time for the hearing on the complaint. Dr. Sharma sought a continuance, and a hearing was set for

       March 4, 2021, two days after the original notice date.

¶8            On March 4, 2021, an administrative hearing was held. The Administrative Law Judge

       (ALJ) denied the motion to limit hearing, explaining that it lacked a legal basis but Dr. Sharma

       could have a continuance. Dr. Sharma provided that he was ready to proceed. The Department

       rested in reliance on four exhibits: the current complaint, the 2021 Oregon order (license

       surrendered), the 2015 Oregon order (license revoked but stayed), and the 2015 Illinois order

       (license reprimanded). Dr. Sharma moved for a directed verdict, arguing that the Department

       introduced no testimony to explain the Oregon discipline, called no expert witnesses, and presented

       no evidence or testimony to support a basis for determining discipline. The ALJ denied the motion.

¶9            Dr. Sharma testified as to the facts surrounding the complained medical events. He

       explained that he elected not to litigate the 2020 Oregon complaint because it would have been

       costly and surrendering his license would cause him to no longer have a stayed revocation from

       the 2015 Oregon order. Dr. Sharma testified that he had not practiced in Oregon since 2012 and

       performed thousands of procedures since the malpractice settlement. At the end of his testimony,

       he attempted to call two expert witnesses to testify regarding the care provided to his patients and

       to demonstrate that his care was within the standard of care. Dr. Sharma argued that the testimony

       was necessary to explain the Department’s exhibits and show why any discipline should be

       mitigated. The ALJ denied his request to allow expert witnesses to testify.

¶ 10          On May 13, 2021, the ALJ filed a report and recommendation with the Illinois Medical

       Disciplinary Board (Board). The ALJ found that Dr. Sharma’s voluntary surrender of his license

       in lieu of the Oregon Medical Board terminating its investigation constituted disciplinary action

       within the meaning of section 22(A)(12) of the Act. The ALJ recommended that Dr. Sharma’s

                                                        4
       Illinois license be subject to an indefinite suspension for a minimum of 18 months. The ALJ

       explained that discipline was justified, as Dr. Sharma’s history of discipline demonstrated “an

       indifference to compliance with the standards of care and an indifference to the rules governing

       the profession.” The ALJ expressed concern that Dr. Sharma continuously asserted that he did not

       do any of the things alleged as part of the Oregon discipline. The ALJ stated that the circumstances

       presented had potential to result in severe harm to the public.

¶ 11          On June 2, 2021, the Board presented a report of its findings of fact, conclusions of law,

       and recommendation to the Director. The Board stated it reviewed the record in the matter and

       adopted the ALJ’s report. The Board also recommended that Dr. Sharma’s Illinois license be

       indefinitely suspended for a minimum of 18 months. The report was signed by the Board’s

       chairperson.

¶ 12          On June 23, 2021, Dr. Sharma filed a motion for exceptions and rehearing, arguing (1) a

       member of the Board failed to appear in person at the hearing, as required by law, (2) the Board’s

       recommendation did not comply with the law as there was no specific indication that the Board

       members reviewed the transcript, (3) the ALJ improperly denied his motion to limit the hearing,

       violating his due process rights, (4) the Department failed to introduce testimony to support

       disciplinary action, (5) the ALJ’s conclusions of law conflicted with the evidence and testimony

       presented and disallowed at the hearing, and (6) the recommended discipline was unsupported by

       the findings of fact in the ALJ’s report and not in furtherance of the purpose of the Act.

¶ 13          On September 30, 2021, the Department issued an order addressing Dr. Sharma’s

       arguments, finding (1) the Board’s members received a copy of the record prior to making its

       determination, (2) one chairperson’s signature on the Board’s report was allowed per the

       Governor’s Executive Order 2020-07 dated March 16, 2020, which suspended the Open Meetings

                                                        5
       Act’s requirement for in-person attendance by members of a public body, (3) the ALJ properly

       denied his request to limit the formal hearing, (4) the case was based on the sister-state discipline

       and the hearing was not an opportunity to present arguments against the findings of the Oregon

       board, (5) his attempt to relitigate conduct that led to the Oregon stipulated order was not reflective

       of someone who accepted the reality of the situation and he instead needed to address the 2021

       Oregon stipulated order in the context of sister-state discipline, and (6) expert testimony was

       unnecessary. Dr. Sharma’s Illinois license was indefinitely suspended for a minimum of 18

       months. The Department considered various factors, such as the seriousness of the conduct that

       led to the Oregon discipline, prior disciplinary action, lack of contrition for the offenses, and the

       fact that Dr. Sharma modified his practices following the death of his patient in 2016.

¶ 14          Dr. Sharma sought review of the Department’s decision before the court. The court found

       that Dr. Sharma’s primary argument was that he was not given a formal adversarial hearing and

       rejected that claim. The court provided that, when a professional accepts the consequences for an

       adverse action in another state, this is tantamount, by statute, to accepting the consequences in

       Illinois too (citing 225 ILCS 60/22(12) (West 2020), Ming Kow Hah v. Stackler, 66 Ill. App. 3d

       947 (1978), and Gross v. Department of Financial & Professional Regulation, 2011 IL App (1st)

       103101). Thus, the court concluded, because Dr. Sharma was given a hearing on whether adverse

       action was taken against his Oregon medical license, there was no basis to conclude that he did

       not receive due process. As to other arguments raised by Dr. Sharma, the court accepted the

       Department’s position. Dr. Sharma appealed.

¶ 15                                          II. ANALYSIS

¶ 16          The Act provides that all final administrative decisions of the Department are subject to

       judicial review, pursuant to the Administrative Review Law (735 ILCS 5/3-101 et seq. (West

                                                         6
       2020)). 225 ILCS 60/41 (West 2020). Such review shall extend to all questions of law and fact

       presented by the entire record before the court, and thus, no new or additional evidence shall be

       heard. 735 ILCS 5/3-110 (West 2020). Further, this court reviews the decision of the agency, not

       the decision of the circuit court. Pasic v. Department of Financial & Professional Regulation,

       2022 IL App (1st) 220076, ¶ 17. Our standard of review varies depending on the issues presented.

       Questions of law are reviewed de novo, findings of fact are deemed prima facie true and correct

       and will not be disturbed unless they are against the manifest weight of the evidence, and mixed

       questions of law and fact are reviewed for clear error. Id. ¶¶ 17-19.

¶ 17                                         A. Due Process

¶ 18          First, Dr. Sharma argues that his due process rights were violated. Administrative

       proceedings are governed by the fundamental principles and requirements of due process of law.

       Abrahamson v. Illinois Department of Professional Regulation, 153 Ill. 2d 76, 92 (1992). An

       administrative hearing comports with due process where the parties are given (1) the opportunity

       to be heard, (2) the right to cross-examine adverse witnesses, and (3) impartiality in ruling on the

       evidence. Wolin v. Department of Financial & Professional Regulation, 2012 IL App (1st) 112113,

       ¶ 25. However, a court will only find a due process violation if there is a showing of prejudice. Id.

       A claimed due process violation presents a question of law, which we review de novo. Id.

¶ 19          Dr. Sharma contends that his due process rights were violated because his requests for a

       hearing on his temporary suspension were denied and his temporary suspension lasted for nine

       months (from February 19, 2021, to September 30, 2021). Therefore, he argues that he should have

       been given a hearing on the temporary suspension within 15 days and then a hearing on the

       complaint after he had been given adequate time to gather information and prepare.

¶ 20          This presents a question of law involving statutory interpretation, which we review

                                                        7
       de novo. Slepicka v. Illinois Department of Public Health, 2014 IL 116927, ¶ 13. “In determining

       the meaning of a statute, a court will not read language in isolation, but must consider it in the

       context of the entire statute.” Id. ¶ 14. Where a statute is clear and unambiguous, we are not at

       liberty to depart from its plain language and meaning by imposing exceptions, limitations, or

       conditions that the legislature did not express. Solich v. George & Anna Portes Cancer Prevention

       Center of Chicago, Inc., 158 Ill. 2d 76, 83 (1994).

¶ 21          The Department’s authority to temporary suspend the license of a physician lies within

       section 37(d) of the Act, which states:

                      “The Secretary, after consultation with the Chief Medical Coordinator or Deputy

                      Medical Coordinator, may temporarily suspend the license of a physician without

                      a hearing, simultaneously with the institution of proceedings for a hearing provided

                      under this Section if the Secretary finds that evidence in his or her possession

                      indicates that a physician’s continuation in practice would constitute an immediate

                      danger to the public. In the event that the Secretary suspends, temporarily, the

                      license of a physician without a hearing, a hearing by the Disciplinary Board shall

                      be held within 15 days after such suspension has occurred and shall be concluded

                      without appreciable delay.” 225 ILCS 60/37(d) (West 2020).

¶ 22          Dr. Sharma argues that the language in section 37(d) provides for a hearing within 15 days

       as to the temporary suspension and not the complaint. The Department responds that this

       interpretation is (1) absurd because it would mean that a licensee would be entitled to only have

       the temporary suspension heard on an expedited basis and (2) inconsistent with due process

       protections recognized by the United States Supreme Court (citing Mitchell v. W.T. Grant Co., 416

       U.S. 600, 611 (1974), for the proposition that due process does not require a hearing at a

                                                        8
       preliminary stage as long as the requisite hearing is held before the final administrative order

       becomes effective).

¶ 23          We agree with the Department and find that the clear and unambiguous language of section

       37(d) provides for a temporary suspension without any hearing as to the temporary suspension

       itself. This is conditioned upon the fact that the temporary suspension is sought simultaneously

       with the institution of proceedings for a hearing. Thus, the requirement of a hearing within 15 days

       applies to the institution of proceedings, such as the underlying complaint in this case, where a

       temporary suspension without a hearing has already been granted. See 225 ILCS 60/37(d) (West

       2020). Although a temporary suspension without a hearing is a serious measure, it is in keeping

       with the legislature’s intent to increase the Department’s disciplinary powers where a physician

       poses a danger to the public. See 85th Ill. Gen. Assem., Senate Proceedings, May 14, 1987, at 76

       (statements of Senator Jones).

¶ 24          Dr. Sharma alternatively argues that he was entitled to at least 30 days’ notice before a

       formal hearing to prepare and gather evidence (citing 225 ILCS 60/36(b) (West 2020)). He fails

       to address that the ALJ offered to continue the matter, which he declined, and stated that he was

       ready to proceed. He waived this issue. See Center Partners, Ltd. v. Growth Head GP, LLC, 2012

       IL 113107, ¶ 66 (waiver arises from an affirmative, consensual act consisting of an intentional

       relinquishment of a known right). Dr. Sharma also argues that he needed to acquire certain

       discovery to prepare his case but he fails to specify which documents he sought and never obtained

       or how this impaired his defense.

¶ 25          Next, Dr. Sharma raises claims related to section 37(a) of the Act, which provides:

                      “At the time and place fixed in the notice, the Disciplinary Board provided for in

                      this Act shall proceed to hear the charges, and the accused person shall be accorded

                                                        9
                      ample opportunity to present in person, or by counsel, such statements, testimony,

                      evidence and argument as may be pertinent to the charges or to any defense thereto.

                      The Disciplinary Board may continue such hearing from time to time. If the

                      Disciplinary Board is not sitting at the time and place fixed in the notice or at the

                      time and place to which the hearing has been continued, the Department shall

                      continue such hearing for a period not to exceed 30 days.” 225 ILCS 60/37(a) (West

                      2020).

¶ 26          He first argues that section 37(a) provides that he was entitled to the opportunity to present

       expert testimony as to standard of care and what, if any, discipline should be imposed. Here, the

       ALJ reasoned that expert testimony was unnecessary because the question was whether adverse

       action was taken in another state or jurisdiction against Dr. Sharma’s medical license. The statute’s

       language states that Dr. Sharma may present such testimony that is pertinent to the charges or his

       defense. Id. The ALJ and Department found that such testimony was not pertinent as to whether

       the sister-state discipline provision was violated, and we agree.

¶ 27          Dr. Sharma also contends that section 37(a) requires a member of the Board to be present

       at the formal hearing. He points to specific language that the Board must “hear” the charges and

       that the Board must continue the hearing if it is “not sitting at the time and place fixed in the

       notice.” Id. Dr. Sharma cites Abrahamson, 153 Ill. 2d at 95, where the court stated, “[I]t is

       sufficient if even only one Board member listened to the live testimony.” However, this language

       from Abrahamson was made within the context of the facts before it. The supreme court did not

       analyze section 37(a) or make a new rule. See Masood v. Division of Professional Regulation of

       the Department of Financial & Professional Regulation, 2022 IL App (1st) 220657, ¶ 76

       (“Abrahamson determined that the presence of one Board member was sufficient to afford due

                                                        10
       process, it did not conclude that it was necessary.” (Emphases in original.)). Instead, it explained

       that “absent express statutory language to the contrary, agency members making the final decision

       need not be present when the evidence is taken, so long as they review the record of proceedings.”

       Abrahamson, 153 Ill. 2d at 95; see Kafin v. Division of Professional Regulation of the Department

       of Financial & Professional Regulation, 2012 IL App (1st) 111875, ¶ 33 (holding that Board

       members need not be present when evidence is taken, as long as they review the record of

       proceedings before providing its recommendation).

¶ 28          Dr. Sharma also takes issue with the fact that the Board’s recommendation was only signed

       by the Board’s chairperson and not by all of its members. He states that the chairperson did not

       constitute a quorum and the chairperson’s signature did not indicate that it was founded in authority

       from the majority. We reject this argument. First, the Board’s recommendation to the Director

       provides that it was made by a majority of its members. Second, Dr. Sharma points to no authority

       requiring that each Board member sign the recommendation. Third, the Director’s order provided

       that, at the time of the Board’s meeting, the Governor issued an executive order suspending the

       requirement for in-person attendance by members of a public body. The chairperson signed the

       Board’s report on behalf of the Board, which was operating remotely. See Masood, 2022 IL App

       (1st) 220657, ¶ 79 (rejecting the same argument).

¶ 29          The last due process violation Dr. Sharma claims is that there was no evidence that the

       absent Board members reviewed the transcript from the hearing. He recognizes the Board’s

       statement that it reviewed the record but argues that the transcript is not mentioned. We presume

       that the Board acted lawfully and find that he failed to rebut this presumption. See Watra, Inc. v.

       License Appeal Comm’n, 71 Ill. App. 3d 596, 601 (1979) (“An administrative agency *** is

       entitled to a presumption that all of its official acts have been performed properly and this

                                                        11
       presumption extends to a reading and consideration of the evidence.”).

¶ 30          For these reasons, we find that Dr. Sharma’s due process rights were not violated.

¶ 31                                          B. Violation of the Act

¶ 32          Second, Dr. Sharma contends that the Department’s determination that he violated section

       22(A)(12) of the Act (225 ILCS 60/22(A)(12) (West 2020)) was clearly erroneous. Under this

       standard of review, we will reverse if we are left with the definite and firm conviction that a mistake

       has been made. AFM Messenger Service, Inc. v. Department of Employment Security, 198 Ill. 2d

       380, 393 (2001). Dr. Sharma does not dispute that the voluntary surrender of his Oregon license

       constituted a basis for discipline under the Act. Instead, he contends that (1) the Department failed

       to establish such violation because it did not introduce expert testimony and (2) the record from

       the Oregon proceedings was insufficient.

¶ 33          Dr. Sharma argues that Illinois law is clear in that the Department must present expert

       testimony to support its finding of a violation and any deviations from the standard of care. He

       cites two cases to support this proposition, which we find inapposite as they do not involve an

       alleged violation of the sister-state discipline provision. See Obasi v. Department of Professional

       Regulation, 266 Ill. App. 3d 693 (1994) (expert testimony was used to evaluate whether the

       physician’s conduct constituted patient abandonment); Farney v. Anderson, 56 Ill. App. 3d 677

       (1978) (the proceedings were fatally tainted where a subjective analysis on the part of a medical

       panel was used in place of an expert medical opinion). It is evident that he attempts to dispute the

       underlying allegations that led to the 2020 Oregon discipline, when those facts are irrelevant in

       establishing a violation of the sister-state discipline provision. It is true that where an

       administrative agency makes a factual determination that involves technical concepts unique to its

       expertise, expert testimony must be introduced to support the agency’s position. Chase v.

                                                         12
       Department of Professional Regulation, 242 Ill. App. 3d 279, 285 (1993). Here, however, the

       factual determination that the Department needed to make was whether adverse action had been

       taken by another state or jurisdiction against Dr. Sharma’s medical license. See 225 ILCS

       60/22(A)(12) (West 2020). This did not entail a technical concept requiring expertise.

¶ 34          Dr. Sharma also disputes the Department’s finding of a violation on the basis that there

       was no “certification that the record from Oregon was complete,” and suggests that there were

       documents absent from the record. See 5 ILCS 100/10-35 (West 2020). Dr. Sharma references

       specific language in section 22(A)(12) that provides “a certified copy of the record of the action

       taken by the other state or jurisdiction being prima facie evidence thereof.” 225 ILCS 60/22(A)(12)

       (West 2020). The Department argues that Dr. Sharma forfeited this argument by failing to raise it

       at the administrative hearing or in his motion for exceptions and rehearing. In the alternative, the

       Department argues that the clear and unambiguous language refers to a certified copy of the record

       of the action taken, such as an order, and not the entire record. We find that Dr. Sharma forfeited

       this contention by failing to raise it in a timely manner and decline to consider it. See Cinkus v.

       Village of Stickney Municipal Officers Electoral Board, 228 Ill. 2d 200, 214 (2008) (issues not

       presented before the administrative agency will not be considered for the first time on review).

¶ 35          Therefore, we find that the Department’s determination that Dr. Sharma violated section

       22(A)(12) of the Act was not clearly erroneous. 225 ILCS 60/22(A)(12) (West 2020).

¶ 36                                                 C. Discipline

¶ 37          Last, Dr. Sharma takes issue with the Department’s decision to indefinitely suspend his

       Illinois license for a minimum of 18 months. He asks this court to first examine whether an

       indefinite suspension is authorized by law. Section 22 of the Act provides, in relevant part:

                      “The Department may revoke, suspend, place on probation, reprimand, refuse to

                                                       13
                      issue or renew, or take any other disciplinary or non-disciplinary action as the

                      Department may deem proper with regard to the license or permit of any person

                      issued under this Act, including imposing fines not to exceed $10,000 for each

                      violation ***.” Id.

¶ 38          Dr. Sharma argues that the word “indefinite” does not appear in the Act and that a

       suspension must have a definite term. He entirely relies on section 43 of the Act that provides for

       the restoration of a license from discipline, which states: “At any time after the successful

       competition of a term of probation, suspension, or revocation of a license, the Department may

       restore the license to the licensee, unless after an investigation and a hearing, the Secretary

       determines that restoration is not in the public interest.” Id. § 43. Dr. Sharma argues that an

       indefinite suspension is contrary to law as section 43 contemplates a definite term. The Department

       argues that licenses need not be suspended for a set term and then automatically restored because

       it would essentially render section 43 superfluous. Additionally, the Department explains that,

       after 18 months, Dr. Sharma may seek restoration of his license.

¶ 39          The same statutory interpretation rules apply here. Supra ¶ 20. Section 22(A) provides for

       various forms of disciplinary action, including suspensions, and even states that the Department

       may “take any other disciplinary or non-disciplinary action as the Department may deem proper.”

       225 ILCS 60/22(A) (West 2020). This undoubtedly includes indefinite suspensions, and we

       decline to impose a limitation that the legislature did not express. Recently, in Masood, 2022 IL

       App (1st) 220657, ¶ 81, the First District found that indefinite suspensions were authorized under

       providing for the restoring a license following a term of suspension. We agree.

¶ 40          Further, Dr. Sharma’s reliance on section 43 for the proposition that a suspension must be

       set for a definite term is misplaced. He acknowledges that when discipline is indefinite, it requires

                                                        14
       the licensee to apply to the Disciplinary Board for restoration of license (citing 68 Ill. Adm. Code

       § 1285.255 (2005)). Dr. Sharma insists that it “makes more sense” that imposing a definite term

       with “specific goals” would be in keeping with the Act and the Department failed to establish

       specific goals for rehabilitation. But the criteria that the Disciplinary Board shall consider when a

       licensee applies for restoration of a license is already provided by statute. Id. Moreover, Dr.

       Sharma failed to cite any authority suggesting that the Department must provide him with specific

       goals to restore his license. See Obert v. Saville, 253 Ill. App. 3d 677, 682 (1993) (a court of review

       is entitled to have issues clearly defined with pertinent authority cited, and it is not a repository

       into which an appellant may foist the burden of argument and research).

¶ 41          Next, Dr. Sharma argues that the Department abused its discretion in imposing an indefinite

       suspension for a minimum of 18 months because it was not warranted by the underlying facts. An

       agency abuses its discretion when it imposes a sanction that is overly harsh in view of the

       mitigating circumstances or unrelated to the purpose of the Act. Pundy v. Department of

       Professional Regulation, 211 Ill. App. 3d 475, 488 (1991). “The purpose of the Act is to protect

       the public health and welfare from those not qualified to practice medicine.” Kafin, 2012 IL App

       (1st) 111875, ¶ 42. We must defer to the agency’s expertise and experience in determining what

       sanction is appropriate to protect the public interest. Abrahamson, 153 Ill. 2d at 99.

¶ 42          Dr. Sharma raises various sub-arguments, such as the ALJ’s recommended discipline was

       meant to be punitive instead of to protect the public health and welfare, no expert testimony was

       provided, the voluntary surrender of his Oregon license itself does not support the basis of the 18-

       month indefinite suspension, such a lengthy suspension should be reserved for the most severe

       conduct imaginable, the Department prosecutor failed to recommend a term of suspension, and the

       Department improperly considered his disagreement with the Oregon allegations as an aggravating

                                                         15
       factor. He also explains the details of the cases from the Oregon investigation.

¶ 43           The record demonstrates that the Director’s order provides, in more than one instance, that

       the basis for the discipline was to protect the public. Although discipline itself is punitive in nature,

       it is evident from our review of the record that the purpose of the discipline was to protect the

       public and was warranted based on the facts of this case. Dr. Sharma does not compare his situation

       to other instances of discipline or otherwise demonstrate how an indefinite suspension for a

       minimum of 18 months is an abuse of discretion. Also, Dr. Sharma fails to point to any authority

       requiring (1) expert testimony to aid the Director in determining discipline or (2) the Department

       prosecutor to recommend the length of discipline. His attempt to defend against the allegations in

       the Oregon action are also unsuccessful, as already explained by the Department.

¶ 44           As to his point that no expert testimony was offered, we reiterate that expert testimony was

       unnecessary as the issue did not require a factual determination involving technical concepts

       unique to its expertise. Chase, 242 Ill. App. 3d at 285. For example, the factors the Director

       properly considered in aggravation included the seriousness of the conduct that led to the Oregon

       discipline, prior disciplinary action, and lack of contrition for the offenses. See 20 ILCS

       2105/2105-130(b)(1)-(9) (West 2020) (listing factors the Department shall consider in

       aggravation); see Masood, 2022 IL App (1st) 220657, ¶ 85 (finding that the lack of contrition shall

       be considered in aggravation). The Department also appropriately considered in mitigation that

       Dr. Sharma modified his practices following the death of his patient in 2016. See 20 ILCS

       2105/2105-130(c)(1)-(6) (West 2020) (listing factors the Department shall consider in mitigation).

¶ 45           For these reasons, we cannot find that the Department abused its discretion when it

       indefinitely suspended Dr. Sharma’s license for a minimum of 18 months.

                                                          16
¶ 46                                 III. CONCLUSION

¶ 47   For these reasons, the judgment of the circuit court of Will County is affirmed.

¶ 48   Affirmed.

                                               17
 Sharma v. Division of Professional Regulation of the Illinois Department of Financial &
                   Professional Regulation, 2023 IL App (3d) 220095

Decision Under Review:       Appeal from the Circuit Court of Will County, No. 21-MR-
                             2585; the Hon. John C. Anderson, Judge, presiding.

Attorneys                    Michael K. Goldberg, Jenna E. Milaeger, Dominic A. Velloze,
for                          and Jonathan Youseph, of Goldberg Law Group, LLC, of
Appellant:                   Chicago, for appellant.

Attorneys                    Kwame Raoul, Attorney General, of Chicago (Jane Elinor Notz,
for                          Solicitor General, and Bridget DiBattista, Assistant Attorney
Appellee:                    General, of counsel), for appellees.

                                           18