83 FR 61678 - Narciso A. Reyes, M.D.; Decision and Order
DEPARTMENT OF JUSTICE
Drug Enforcement Administration Federal Register Volume 83, Issue 231 (November 30, 2018)
Drug Enforcement Administration
Federal Register Volume 83, Issue 231 (November 30, 2018)
| Page Range | 61678-61681 | |
| FR Document | 2018-26047 |
[Federal Register Volume 83, Number 231 (Friday, November 30, 2018)] [Notices] [Pages 61678-61681] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-26047] ----------------------------------------------------------------------- DEPARTMENT OF JUSTICE Drug Enforcement Administration [Docket No. 18-32] Narciso A. Reyes, M.D.; Decision and Order On April 19, 2018, the Assistant Administrator, Diversion Control Division, Drug Enforcement Administration (hereinafter, DEA or Government), issued an Order to Show Cause to Narciso A. Reyes, M.D. (hereinafter, Respondent), of Luquillo, Puerto Rico. Order to Show Cause (hereinafter, OSC), at 1. The Show Cause Order proposes the revocation of Respondent's DEA Certificate of Registration on the grounds that he materially falsified applications he submitted to DEA and that he has been excluded from participation in a program pursuant to 42 U.S.C. 1320a-7(a). Id. (citing 21 U.S.C. 824(a)(1) and (5)). It also proposes the denial of ``any applications for renewal or modification of such registration and any applications for any other DEA registration.'' OSC, at 1 (citing 21 U.S.C. 824(a)(1) and (5)). Regarding jurisdiction, the Show Cause Order alleges that Respondent holds DEA Certificate of Registration No. FR4900305 at the registered address of Calle Fernandez Garcia 306, Luquillo, Puerto Rico 00773, with a mailing address of P.O. Box 247, Luquillo, PR 00773. OSC, at 2. This registration, the OSC alleges, authorizes Respondent to dispense controlled substances in schedules II through V as a practitioner. Id. The Show Cause Order alleges that this registration expires on April 30, 2020. Id. Regarding the substantive grounds for the proceeding, the Show Cause Order alleges that, on October 20, 2009, the U.S. Department of Health and Human Services, Office of Inspector General (hereinafter, HHS/OIG), mandatorily excluded Respondent from participating in all Federal health care programs due to his conviction in U.S. District Court for conspiracy to commit health care fraud. Id. at 2 (citing 42 U.S.C. 1320a-7(a)(1)). According to the OSC, Respondent's ``mandatory exclusion from Medicare, Medicaid and all Federal health care programs warrants revocation of . . . [his] registration.'' OSC, at 2 (citing 21 U.S.C. 824(a)(5)). The Show Cause Order further alleges that Respondent provided false answers to two ``yes'' or ``no'' liability questions when he applied for a DEA registration on October 16, 2014 and when he filed a renewal application on April 17, 2017. OSC, at 2-3. Specifically, the Show [[Page 61679]] Cause Order alleges that Respondent twice answered that he had never been excluded from participation in a Medicare or state health care program when, in fact, he had been. Id. at 2-3. The Show Cause Order also alleges that Respondent twice answered that he had never surrendered (for cause) a Federal controlled substance registration when, in fact, he had. Id. at 3. According to the OSC, Respondent's answers to these liability questions are ``material falsifications'' that warrant revocation of his registration. Id. The Show Cause Order notifies Respondent of his right to request a hearing on the allegations or to submit a written statement while waiving his right to a hearing, the procedures for electing each option, and the consequences for failing to elect either option. Id. at 3-4 (citing 21 CFR 1301.43). The Show Cause Order also notifies Respondent of the opportunity to submit a corrective action plan. OSC, at 4-5 (citing 21 U.S.C. 824(c)(2)(C)). Respondent timely requested a hearing on May 21, 2018.\1\ Hearing Request, at 1. In his Hearing Request, Respondent states that, ``It was not my intention to fail to declare a material fact in the request for renewal . . . . I do not master the English language well and this may have contributed to these errors.'' Id. He also states in his Hearing Request that, ``My inclusion of the word N in the renewal request was in my estimate to indicate that it did not apply since I had reached an agreement with the US Attorney's Office in Puerto Rico. Clearly my mistake.'' Id. --------------------------------------------------------------------------- \1\ Attached to the Government's Notice of Service of Order to Show Cause is a DEA-12 (Receipt for Cash or Other Items) that, according to the Government's allegations, Respondent executed when the Government served the OSC on April 23, 2018. Respondent did challenge the Government's service-related allegations. Thus, I find that Respondent's Hearing Request was timely since it was filed within 30 days of service of the OSC. 21 CFR 1301.43(a). --------------------------------------------------------------------------- The Office of Administrative Law Judges (hereinafter, OALJ) put the matter on the docket and assigned it to Administrative Law Judge Charles Wm. Dorman (hereinafter, ALJ). I adopt the following statement of procedural history from the ALJ's Order Granting the Government's Motion for Summary Disposition and Recommended Rulings, Findings of Fact, Conclusions of Law, and Decision dated June 22, 2018 (hereinafter, R.D.). On May 31, 2018, the Government filed a Motion for Summary Disposition (``Government's Motion''). The Government's Motion argued that there is no issue of material fact in this case to warrant an adversarial hearing. The Government's Motion further requested that I summarily dispose of this matter without a hearing and recommend to the Acting Administrator that . . . [Respondent's] DEA registration be revoked. On the same day, I issued an Order affording . . . [Respondent] the opportunity to respond to the Government's Motion by June 14, 2018. I explained that if . . . [Respondent] disagreed with any of the Government's statements of undisputed material facts as outlined in its motion for summary disposition, he should provide copies of documentary evidence refuting the Government's statement(s). I further directed . . . [Respondent] to identify the material fact(s) which justify an evidentiary hearing in this case. . . . [Respondent] failed to respond to the Government's Motion by the deadline on June 14, 2018. On June 15, 2018, the day after . . . [Respondent's] Response was due, chambers staff emailed . . . [Respondent's] counsel notifying him that the OALJ had not received a response from him and asking whether he intended to submit a late filing. . . . [Respondent's] counsel replied by email on June 17, 2018, with the following statement: ``There are no allegations on behalf of . . . [Respondent]. The documents are self [e]xplanatory.'' Then, on June 21, 2018, the OALJ received a filing from . . . [Respondent's] counsel titled ``Statement of Narciso A. Reyes, M.D.'' The filing states that . . . [Respondent] ``will not make any statement regarding this administrative action'' and that ``[t]he issue is hereby submitted for final ruling.'' R.D., at 2-3, 7. The ALJ correctly concluded that Respondent's choice not to refute, challenge, or even address any of the Government's reliable and probative evidence and legal arguments ``strongly indicates that he no longer wishes to proceed to hearing.'' Id. at 10. After analyzing the Government's evidence and legal argument, the ALJ granted the Government's Motion for Summary Disposition and recommended that I revoke Respondent's registration and deny any pending applications for renewal or modification. Id. at 10, 18. By letter dated July 16, 2018, the ALJ certified and transmitted the record to me for final Agency action. In that letter, the ALJ advised that neither party filed exceptions and that the time period to do so had expired. I issue this Decision and Order based on the entire record before me. 21 CFR 1301.43(e). I make the following findings of fact. Findings of Fact Respondent's Criminal Conviction and Ensuing Mandatory Exclusion On November 3, 2008, Respondent pled guilty in Federal District Court to one count of conspiracy to commit health care fraud. Government's Motion, GE-2 (Plea Agreement, United States v. Reyes Carrillo, No. 08-cr-168 (D. P.R. Nov. 3, 2008)), at 1. According to the facts submitted by the Assistant United States Attorney and explicitly adopted by Respondent, Respondent signed blank or previously completed false Certificates of Medical Necessity for durable medical equipment for Medicare beneficiaries whom he had never seen. Id. at 9. The Federal District Judge entered judgment against Respondent on March 13, 2009. Government's Motion, GE-3 (Judgment, United States v. Reyes Carrillo, No. 08-cr-168-03 (D. P.R. March 13, 2009)), at 1. Based on Respondent's conviction for conspiracy to commit health care fraud, the HHS/OIG notified Respondent of his mandatory exclusion from participation in any capacity in Medicare, Medicaid, and all Federal health care programs for the minimum statutory period of five years effective October 20, 2009. Government's Motion, GE-4 (HHS/OIG Exclusion Letter), at 1 (citing 42 U.S.C. 1320a-7(a)); Government's Motion, GE-5 (HHS/OIG Exclusions Search Results: Verify), at 1. The HHS/OIG Exclusion Letter advised Respondent that reinstatement of eligibility to participate in these programs is not automatic. Government's Motion, GE-4, at 2. Respondent is still excluded from participation in these programs. Government's Motion, GE-5, at 1. Respondent's DEA Registration History and Current Registration Status On January 31, 2013, Respondent voluntarily surrendered for cause DEA registration No. BR3465944. Government's Motion, GE-8 (Respondent's DEA-104 Voluntary Surrender of Controlled Substances Privileges), at 1; Government's Motion, GE-9 (Certification of Registration History), at 1. Neither the DEA-104 nor any other evidence in the record explains the context of this voluntary surrender. DEA retired registration No. BR3465944 on February 4, 2013. Government's Motion, GE-9, at 1. On October 16, 2014, Respondent submitted an application for a new DEA registration. Government's Motion, GE-10 (Respondent's DEA Form 224 submitted on October 16, 2014), at 1. The application Respondent completed includes ``yes'' or ``no'' liability questions that an applicant must answer to advance to the next page of the online DEA application. Government's Motion, GE-l (Certification of Registration Status), at 2; Government's Motion, GE-10, at 1. The first liability question that Respondent answered on his online DEA application for a registration asks: ``Has the applicant ever been convicted [[Page 61680]] of a crime in connection with controlled substance(s) under state or federal law, or been excluded or directed to be excluded from participation in a medicare or state health care program, or [is] any such action pending?'' Government's Motion, GE-1, at 2; Government's Motion, GE-10, at 1. Respondent answered ``no'' to this question. Government's Motion, GE-1, at 2; Government's Motion, GE-10, at 1. The HHS/OIG Exclusion letter makes it clear that Respondent knew or should have known that his ``no'' response to this question was false. Government's Motion, GE-4, at 1-2. The second liability question that Respondent answered on his online DEA application for a registration asks: ``Has the applicant ever surrendered (for cause) or had a federal controlled substance registration revoked, suspended, restricted or denied, or is any such action pending?'' Government's Motion, GE-l, at 2; Government's Motion, GE-10, at 1. Respondent answered ``no'' to this question. Government's Motion, GE-1, at 2; Government's Motion, GE-10, at 1. The DEA-104 Voluntary Surrender of Controlled Substances Privileges form that Respondent signed, however, makes it clear that Respondent knew or should have known that his ``no'' response to this question was false. Government's Motion, GE-8, at 1. DEA approved Respondent's application and, on October 17, 2014, assigned DEA Certificate of Registration No. FR4900305 to him. Government's Motion, GE-1, at 1. On April 17, 2017, Respondent submitted an online DEA renewal application for his DEA registration No. FR4900305. Government's Motion, GE-1, at 1; Government's Motion, GE-11 (Respondent's DEA Form 224A submitted on April 17, 2017), at 1. The online DEA renewal application Respondent submitted includes ``yes'' or ``no'' liability questions that an applicant must answer to advance to the next page of the online DEA renewal application. Government's Motion, GE-l, at 1; Government's Motion, GE-11, at 1. The first liability question that Respondent answered on his online DEA renewal application asks: ``Has the applicant ever been convicted of a crime in connection with controlled substance(s) under state or federal law, or been excluded or directed to be excluded from participation in a medicare or state health care program, or [is] any such action pending?'' Government's Motion, GE-1, at 1; Government's Motion, GE-11, at 1. Respondent answered ``no'' to this question. Government's Motion, GE-1, at 1; Government's Motion, GE-11, at 1. Again, the HHS/OIG Exclusion letter makes it clear that Respondent knew or should have known that his ``no'' response to this question was false. Government's Motion, GE-4, at 1-2. The second liability question that Respondent answered on his online DEA renewal application asks: ``Has the applicant ever surrendered (for cause) or had a federal controlled substance registration revoked, suspended, restricted or denied, or is any such action pending?'' Government's Motion, GE-l, at 1; Government's Motion, GE-11, at 1. Respondent answered ``no'' to this question. Government's Motion, GE-1, at 1; Government's Motion, GE-11, at 1. Again, the DEA- 104 Voluntary Surrender of Controlled Substances Privileges form that Respondent signed makes it clear that Respondent knew or should have known that his ``no'' response to this question was false. Government's Motion, GE-8, at 1. DEA approved Respondent's renewal application on April 19, 2017. Government's Motion, GE-1, at 1. In sum, Respondent is currently registered as a practitioner in schedules II through V under DEA Certificate of Registration FR4900305 at Calle Fernandez Garcia 306, Luquillo, Puerto Rico 00773. Government's Motion, GE-1, at 1. Respondent's registration expires on April 30, 2020. Id. Discussion The Material Falsification Allegation Pursuant to 21 U.S.C. 824(a)(1), the Attorney General may suspend or revoke a registration issued under section 823 of Title 21, ``upon a finding that the registrant . . . has materially falsified any application filed pursuant to or required by this subchapter.'' According to Agency precedent, the Government must show that a respondent ``knew or should have known'' that his response to a liability question was false. Samuel S. Jackson, D.D.S., 72 FR 23,848, 23,852 (2007). Also according to Agency precedent, a respondent's claim that he misunderstood a liability question is not a defense. Alvin Darby, M.D., 75 FR 26,993, 26,999 (2010). According to the Supreme Court, Federal courts' ``most common formulation'' of the concept of ``materiality'' is that ``a concealment or misrepresentation is material if it `has a natural tendency to influence, or was capable of influencing, the decision of' the decisionmaking body to which it was addressed.'' Kungys v. United States, 485 U.S. 759, 770 (1988) (quoting Weinstock v. United States, 231 F.2d 699, 701-02 (D.C. Cir. 1956) (other citation omitted)). The Court explicitly addressed what has ``never been the test of materiality[--] that the misrepresentation or concealment would more likely than not have produced an erroneous decision, or even that it would more likely than not have triggered an investigation.'' Kungys, supra, 485 U.S. at 771 (emphasis in original). Instead, the Court articulated the specific test as ``whether the misrepresentation or concealment was predictably capable of affecting, i.e., had a natural tendency to affect, the official decision.'' Id. As already discussed, when Respondent submitted an online DEA application for a registration and an online DEA renewal application, he answered ``no'' to whether he had ever been excluded from participation in Medicare and to whether he had ever surrendered a registration for cause. As I already found above, Respondent's four answers were false and he ``knew or should have known'' that they were false. I next determine the ``materiality'' of Respondent's four answers. 21 U.S.C. 824(a)(1). Concerning Respondent's false statements about his voluntary surrender of DEA registration No. BR3465944, the DEA-104 that Respondent executed does not indicate the underlying reason(s) for Respondent's ``alleged failure to comply with the Federal requirements pertaining to controlled substances.'' Government's Motion, GE-8, at 1. Further, as the ALJ noted, the DEA-104 reveals nothing about whether Respondent's ``alleged failure'' ``had a natural tendency to affect'' an Agency decision. R.D., at 13-14 (quoting Michel P. Toret, M.D., 82 FR 60,041, 60,043 (2017) quoting Kungys, supra, 485 U.S. at 771). I found no evidence in the record concerning the materiality of Respondent's two false answers about his voluntary surrender. Thus, I agree with the ALJ that the record does not support a finding that Respondent's two false answers about his voluntary surrender of registration No. BR3465944 were ``materially'' false. 21 U.S.C. 824(a)(1). Concerning Respondent's false statements regarding his mandatory exclusion, the Agency has never before considered the materiality of a respondent's false answers about his mandatory exclusion as that question is posed in this case. I find the ALJ's analysis persuasive: ``Considering that exclusion from a federal health care program under 42 U.S.C. 1320a-7(a) is an independent basis for revoking [a] [[Page 61681]] registration . . ., it is reasonable to conclude that information regarding an applicant's mandatory exclusion by HHS would be `capable of influencing the [DEA's] decision.' '' R.D., at 13 (citations omitted). I agree with the ALJ. I find that Respondent's failure to disclose his mandatory exclusion from a Federal health care program is material. Id. Thus, I find that there is substantial evidence in the record that Respondent materially falsified a DEA registration application and a DEA registration renewal application concerning his mandatory exclusion. 21 U.S.C. 824(a)(1). The Allegation of Mandatory Exclusion From a Federal Health Care Program Pursuant to 21 U.S.C. 824(a)(5), the Attorney General may suspend or revoke a registration issued under section 823 of Title 21, ``upon a finding that the registrant . . . has been excluded . . . from participation in a program pursuant to section 1320a-7(a) of Title 42.'' Agency precedent makes clear that revocation under 21 U.S.C. 824(a)(5) may be appropriate regardless of whether or not the misconduct that led to the mandatory exclusion involved controlled substances. KK Pharmacy, 64 FR 49,507, 49,510 (1999) (collecting cases) (The Agency ``has previously held that misconduct which does not involve controlled substances may constitute grounds, under 21 U.S.C. 824(a)(5), for the revocation of a DEA Certificate of Registration.''); Melvin N. Seglin, M.D., 63 FR 70,431, 70,433 (1998) (``[M]isconduct which does not involve controlled substances may constitute grounds for the revocation of a DEA registration pursuant to 21 U.S.C. 824(a)(5).''); Stanley Dubin, D.D.S., 61 FR 60,727, 60,728 (1996) (Registration revoked and pending applications for renewal denied when registrant's ``actions cast substantial doubt on . . . [his] integrity.''); George D. Osafo, M.D., 58 FR 37,508, 37,509 (1993) (Submission of fraudulent medical claims and larceny convictions indicated that registrant ``placed monetary gain above the welfare of his patients, and in so doing, endangered the public health and safety.''). Under 42 U.S.C. 1320a-7(a)(1), the HHS OIG is required to exclude from participation in any Federal health care program any individual who has been convicted of a criminal offense ``related to the delivery of an item or service under . . . [42 U.S.C. 1395 et seq.] or under any State health care program.'' Based on the uncontroverted evidence in the record, as already discussed, I found that Respondent has been excluded from participation in any capacity in Medicare, Medicaid, and all Federal health care programs and that Respondent is still excluded from participation in these programs. Accordingly, I find that the evidence in the record satisfies the Government's prima facie burden to support the revocation of Respondent's registration under 21 U.S.C. 824(a)(5). Sanction Where, as here, the Government has met its prima facie burden, the burden shifts to Respondent to show why he can be entrusted with a registration. Respondent, however, did not submit evidence for the record. Instead, he stated that the documents are self-explanatory, that he ``will not make any statement regarding this administrative action,'' and that ``[t]he issue is hereby submitted for final ruling.'' R.D., at 7. Thus, the question now is whether revocation is the appropriate sanction under the facts I have found: Two separate violations whose statutory sanctions include revocation. 21 U.S.C. 824(a)(1) and (5). I agree with the ALJ's analysis and conclude that revocation is independently the appropriate sanction for each of the separate violations the facts support. In particular, I agree with the ALJ's analysis that, even though the underlying misconduct which led to Respondent's conviction and mandatory exclusion did not involve controlled substances, it did involve the unlawful use of Respondent's prescribing authority. R.D., at 17. As the ALJ stated, ``This type of fraudulent behavior does not inspire confidence that . . . [Respondent] can be trusted with a prescription pad bearing a DEA registration number.'' Id. After all, if Respondent signed blank certificates of medical necessity for durable medical equipment that was not medically necessary, ``it is doubtful that DEA can expect . . . [Respondent] to honestly prescribe controlled substances for only legitimate medical purposes.'' Id. Further, Respondent materially falsified two DEA applications. One such falsification, alone, is sufficient, without proof of any other misconduct, to revoke a registration. Toret, supra, 82 FR at 60,043. As the ALJ stated, ``[N]ot only has the Government proven two independent bases for revoking . . . [Respondent's] registration . . ., but . . . [Respondent] has not advanced any evidence that he `can be trusted to responsibly discharge his obligations as a registrant.' '' R.D., at 17- 18 (citation omitted). Accordingly, based on the evidence in the record supporting two independent bases for revocation, I shall order that Respondent's DEA registration be revoked and that any pending application of Respondent to renew or to modify that registration be denied. Order Pursuant to 28 CFR 0.100(b) and the authority thus vested in me by 21 U.S.C. 824(a), I order that DEA Certificate of Registration No. FR4900305 issued to Narciso A. Reyes, M.D., be, and it hereby is, revoked. Pursuant to 28 CFR 0.100(b) and the authority thus vested in me by 21 U.S.C. 823(f), I further order that any pending application of Narciso A. Reyes, M.D., to renew or to modify this registration, be, and it hereby is, denied. This Order is effective December 31, 2018. Dated: November 19, 2018. Uttam Dhillon, Acting Administrator. [FR Doc. 2018-26047 Filed 11-29-18; 8:45 am] BILLING CODE 4410-09-P
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Where a registrant has lost state authority to R.D., at 3–4. DEPARTMENT OF JUSTICE
handle controlled substances, the Agency has It is undisputed that Respondent is
repeatedly taken the position that not currently authorized to practice Drug Enforcement Administration
‘‘revocation is warranted even where a medicine in Arizona due to the Interim
practitioner’s state authority has been [Docket No. 18–32]
summarily suspended and the State has yet
Consent Agreement. Thus, according to
to provide the practitioner with a hearing to Arizona law, Respondent does not have Narciso A. Reyes, M.D.; Decision and
challenge the State’s action and at which he authority to handle controlled Order
. . . may ultimately prevail.’’ Kamal Tiwari, substances in Arizona, the State in
M.D., 76 FR 71604, 71606 (2011) (citations which he is registered with the DEA. As On April 19, 2018, the Assistant
omitted); see also Anne Lazar Thorn, M.D., already discussed, the practice Administrator, Diversion Control
62 FR 12847, 12848 (1997) (‘‘[T]he restriction on Respondent’s medical Division, Drug Enforcement
controlling question is not whether a license is currently in effect. DEA has Administration (hereinafter, DEA or
practitioner’s license to practice medicine in Government), issued an Order to Show
the state is suspended or revoked; rather, it
‘‘long and consistently interpreted the
CSA as mandating the possession of Cause to Narciso A. Reyes, M.D.
is whether the Respondent is currently
authorized to handle controlled substances in authority under state law to handle (hereinafter, Respondent), of Luquillo,
the [state of registration].’’). Even when the controlled substances as a fundamental Puerto Rico. Order to Show Cause
Respondent is actively engaged in appealing condition for obtaining and maintaining (hereinafter, OSC), at 1. The Show
a state decision, the Agency has noted that a registration.’’ Hooper, supra, 76 FR at Cause Order proposes the revocation of
‘‘[i]t is not DEA’s policy to stay 71,371. That is the controlling question. Respondent’s DEA Certificate of
[administrative] proceedings . . . while Thorn, supra, 62 FR at 12,848. The CSA Registration on the grounds that he
registrants litigate in other forums.’’ Newcare materially falsified applications he
Home Health Servs., 72 FR 42126, 42127 n.2 has consistently been interpreted to
mean that ‘‘DEA does not have statutory submitted to DEA and that he has been
(2007). Agency precedent has consistently
affirmed recommended decisions where a authority . . . to maintain a registration excluded from participation in a
respondent’s request for a stay due to state if the registrant is without state program pursuant to 42 U.S.C. 1320a–
medical board proceedings were denied by authority to handle controlled 7(a). Id. (citing 21 U.S.C. 824(a)(1) and
the Administrative Law Judge. See, e.g., Irwin substances in the state in which he (5)). It also proposes the denial of ‘‘any
August, D.O., 81 FR 3158, 3159 (2016); Pedro practices.’’ Yeates, supra, 71 FR at applications for renewal or modification
E. Lopez, M.D., 80 FR 46324, 46325–26 of such registration and any
(2015). The Agency has stated in recent final
39,131. As succinctly explained by the
CALJ, ‘‘The DEA has long held that applications for any other DEA
orders that a stay in administrative registration.’’ OSC, at 1 (citing 21 U.S.C.
enforcement proceedings is ‘‘unlikely to ever possession of authority under state law
be justified’’ due to ancillary proceedings to dispense controlled substances is not 824(a)(1) and (5)).
involving the Respondent. Grider Drug #1 & only a prerequisite to obtaining a DEA Regarding jurisdiction, the Show
Grider Drug #2, 77 FR 44070, 44104 n.97 registration, but also an essential Cause Order alleges that Respondent
(2012). condition for maintaining it.’’ R.D., at 5 holds DEA Certificate of Registration
Even if the Agency’s precedent were not
(citations omitted). I agree with the No. FR4900305 at the registered address
fixed firmly against the granting of such a of Calle Fernandez Garcia 306, Luquillo,
delay in principle, the Respondent here is CALJ’s conclusion that ‘‘as a matter of
law, a DEA registration may not be Puerto Rico 00773, with a mailing
unable to point to a reliably fixed date where address of P.O. Box 247, Luquillo, PR
state proceedings would reasonably be granted or maintained where an
concluded. The Respondent’s Motion applicant/registrant no longer falls 00773. OSC, at 2. This registration, the
includes a Declaration from the Respondent’s within the CSA’s definition of a OSC alleges, authorizes Respondent to
counsel (Respondent’s Board Counsel) in his practitioner.’’ Id. Very simply, since dispense controlled substances in
Arizona Board proceedings. . . . Respondent is not authorized to handle schedules II through V as a practitioner.
[Respondent’s Motion,] Attachment 1. In the Id. The Show Cause Order alleges that
Respondent’s Board Counsel’s declaration, controlled substances in Arizona, he is
not eligible for a DEA registration. As this registration expires on April 30,
the decisional timeframe is couched in the 2020. Id.
following tenuous terms: such, I will order that Respondent’s
Regarding the substantive grounds for
As for when the [Arizona Board] might DEA registration be revoked.
take action, my best guess is that it will be the proceeding, the Show Cause Order
at its August 20, 2018 meeting, although I Order alleges that, on October 20, 2009, the
would not be surprised if [the Respondent’s] Pursuant to 28 CFR 0.100(b) and the U.S. Department of Health and Human
matter is not heard until the October 22 authority thus vested in me by 21 U.S.C. Services, Office of Inspector General
meeting, which is the next regularly 824(a), I order that DEA Certificate of (hereinafter, HHS/OIG), mandatorily
scheduled meeting of the [Arizona Board]. excluded Respondent from participating
Registration No. BF3649312 issued to
Id. at 2–3 (emphasis supplied). The Steve Fanto, M.D., be, and it hereby is, in all Federal health care programs due
Respondent’s Board Counsel further to his conviction in U.S. District Court
explained that the state process involves the revoked. Pursuant to 28 CFR 0.100(b)
and the authority thus vested in me by for conspiracy to commit health care
actions and recommendations of an internal
21 U.S.C. 823(f), I further order that any fraud. Id. at 2 (citing 42 U.S.C. 1320a–
committee, and avers that he and the
Respondent ‘‘are hopeful that [the internal pending application of Steve Fanto, 7(a)(1)). According to the OSC,
committee] will make those M.D., to renew or modify this Respondent’s ‘‘mandatory exclusion
recommendations and share them with us in registration, as well as any other from Medicare, Medicaid and all
the not-too-distant future and if that occurs pending application by him for Federal health care programs warrants
then the matter should be heard at the registration in the State of Arizona, be, revocation of . . . [his] registration.’’
August 20 meeting.’’ Id. at 3 (emphasis OSC, at 2 (citing 21 U.S.C. 824(a)(5)).
amozie on DSK3GDR082PROD with NOTICES1
supplied). While the candor of the and it hereby is, denied. This order is
effective December 31, 2018. The Show Cause Order further alleges
Respondent’s Board Counsel is that Respondent provided false answers
commendable, the language strikes as too Dated: November 19, 2018.
aspirational and amorphous to be
to two ‘‘yes’’ or ‘‘no’’ liability questions
Uttam Dhillon, when he applied for a DEA registration
particularly supportive of the delay sought by
the Respondent here—even if the Agency’s Acting Administrator. on October 16, 2014 and when he filed
precedent were not squarely opposed to the [FR Doc. 2018–26046 Filed 11–29–18; 8:45 am] a renewal application on April 17, 2017.
relief—which it is. BILLING CODE 4410–09–P OSC, at 2–3. Specifically, the Show
VerDate Sep<11>2014 17:00 Nov 29, 2018 Jkt 247001 PO 00000 Frm 00080 Fmt 4703 Sfmt 4703 E:\FR\FM\30NON1.SGM 30NON1](https://thefederalregister.org/doc/83_FR_61909/page/1.svg)
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Cause Order alleges that Respondent dispose of this matter without a hearing and Nov. 3, 2008)), at 1. According to the
twice answered that he had never been recommend to the Acting Administrator that facts submitted by the Assistant United
excluded from participation in a . . . [Respondent’s] DEA registration be States Attorney and explicitly adopted
Medicare or state health care program revoked. On the same day, I issued an Order by Respondent, Respondent signed
affording . . . [Respondent] the opportunity
when, in fact, he had been. Id. at 2–3. to respond to the Government’s Motion by
blank or previously completed false
The Show Cause Order also alleges that June 14, 2018. I explained that if . . . Certificates of Medical Necessity for
Respondent twice answered that he had [Respondent] disagreed with any of the durable medical equipment for
never surrendered (for cause) a Federal Government’s statements of undisputed Medicare beneficiaries whom he had
controlled substance registration when, material facts as outlined in its motion for never seen. Id. at 9. The Federal District
in fact, he had. Id. at 3. According to the summary disposition, he should provide Judge entered judgment against
OSC, Respondent’s answers to these copies of documentary evidence refuting the Respondent on March 13, 2009.
liability questions are ‘‘material Government’s statement(s). I further directed Government’s Motion, GE–3 (Judgment,
falsifications’’ that warrant revocation of . . . [Respondent] to identify the material United States v. Reyes Carrillo, No. 08–
his registration. Id. fact(s) which justify an evidentiary hearing in cr–168–03 (D. P.R. March 13, 2009)), at
The Show Cause Order notifies this case. . . . [Respondent] failed to
respond to the Government’s Motion by the
1.
Respondent of his right to request a deadline on June 14, 2018.
Based on Respondent’s conviction for
hearing on the allegations or to submit On June 15, 2018, the day after . . . conspiracy to commit health care fraud,
a written statement while waiving his [Respondent’s] Response was due, chambers the HHS/OIG notified Respondent of his
right to a hearing, the procedures for staff emailed . . . [Respondent’s] counsel mandatory exclusion from participation
electing each option, and the notifying him that the OALJ had not received in any capacity in Medicare, Medicaid,
consequences for failing to elect either a response from him and asking whether he and all Federal health care programs for
option. Id. at 3–4 (citing 21 CFR intended to submit a late filing. . . . the minimum statutory period of five
1301.43). The Show Cause Order also [Respondent’s] counsel replied by email on years effective October 20, 2009.
notifies Respondent of the opportunity June 17, 2018, with the following statement: Government’s Motion, GE–4 (HHS/OIG
to submit a corrective action plan. OSC, ‘‘There are no allegations on behalf of . . . Exclusion Letter), at 1 (citing 42 U.S.C.
[Respondent]. The documents are self
at 4–5 (citing 21 U.S.C. 824(c)(2)(C)). [e]xplanatory.’’
1320a–7(a)); Government’s Motion, GE–
Respondent timely requested a Then, on June 21, 2018, the OALJ received 5 (HHS/OIG Exclusions Search Results:
hearing on May 21, 2018.1 Hearing a filing from . . . [Respondent’s] counsel Verify), at 1. The HHS/OIG Exclusion
Request, at 1. In his Hearing Request, titled ‘‘Statement of Narciso A. Reyes, M.D.’’ Letter advised Respondent that
Respondent states that, ‘‘It was not my The filing states that . . . [Respondent] ‘‘will reinstatement of eligibility to participate
intention to fail to declare a material not make any statement regarding this in these programs is not automatic.
fact in the request for renewal . . . . I administrative action’’ and that ‘‘[t]he issue Government’s Motion, GE–4, at 2.
do not master the English language well is hereby submitted for final ruling.’’ Respondent is still excluded from
and this may have contributed to these R.D., at 2–3, 7. participation in these programs.
errors.’’ Id. He also states in his Hearing The ALJ correctly concluded that Government’s Motion, GE–5, at 1.
Request that, ‘‘My inclusion of the word Respondent’s choice not to refute, Respondent’s DEA Registration History
N in the renewal request was in my challenge, or even address any of the and Current Registration Status
estimate to indicate that it did not apply Government’s reliable and probative
since I had reached an agreement with evidence and legal arguments ‘‘strongly On January 31, 2013, Respondent
the US Attorney’s Office in Puerto Rico. indicates that he no longer wishes to voluntarily surrendered for cause DEA
Clearly my mistake.’’ Id. proceed to hearing.’’ Id. at 10. After registration No. BR3465944.
The Office of Administrative Law analyzing the Government’s evidence Government’s Motion, GE–8
Judges (hereinafter, OALJ) put the and legal argument, the ALJ granted the (Respondent’s DEA–104 Voluntary
matter on the docket and assigned it to Government’s Motion for Summary Surrender of Controlled Substances
Administrative Law Judge Charles Wm. Disposition and recommended that I Privileges), at 1; Government’s Motion,
Dorman (hereinafter, ALJ). I adopt the revoke Respondent’s registration and GE–9 (Certification of Registration
following statement of procedural deny any pending applications for History), at 1. Neither the DEA–104 nor
history from the ALJ’s Order Granting renewal or modification. Id. at 10, 18. any other evidence in the record
the Government’s Motion for Summary By letter dated July 16, 2018, the ALJ explains the context of this voluntary
Disposition and Recommended Rulings, certified and transmitted the record to surrender. DEA retired registration No.
Findings of Fact, Conclusions of Law, me for final Agency action. In that letter, BR3465944 on February 4, 2013.
and Decision dated June 22, 2018 the ALJ advised that neither party filed Government’s Motion, GE–9, at 1.
(hereinafter, R.D.). On October 16, 2014, Respondent
exceptions and that the time period to
submitted an application for a new DEA
On May 31, 2018, the Government filed a do so had expired.
Motion for Summary Disposition registration. Government’s Motion, GE–
I issue this Decision and Order based
(‘‘Government’s Motion’’). The Government’s 10 (Respondent’s DEA Form 224
on the entire record before me. 21 CFR
Motion argued that there is no issue of submitted on October 16, 2014), at 1.
1301.43(e). I make the following
material fact in this case to warrant an The application Respondent completed
adversarial hearing. The Government’s findings of fact.
includes ‘‘yes’’ or ‘‘no’’ liability
Motion further requested that I summarily Findings of Fact questions that an applicant must answer
to advance to the next page of the online
1 Attached to the Government’s Notice of Service Respondent’s Criminal Conviction and
DEA application. Government’s Motion,
amozie on DSK3GDR082PROD with NOTICES1
of Order to Show Cause is a DEA–12 (Receipt for Ensuing Mandatory Exclusion
Cash or Other Items) that, according to the GE–l (Certification of Registration
Government’s allegations, Respondent executed On November 3, 2008, Respondent Status), at 2; Government’s Motion, GE–
when the Government served the OSC on April 23, pled guilty in Federal District Court to 10, at 1.
2018. Respondent did challenge the Government’s one count of conspiracy to commit The first liability question that
service-related allegations. Thus, I find that
Respondent’s Hearing Request was timely since it
health care fraud. Government’s Motion, Respondent answered on his online
was filed within 30 days of service of the OSC. 21 GE–2 (Plea Agreement, United States v. DEA application for a registration asks:
CFR 1301.43(a). Reyes Carrillo, No. 08–cr–168 (D. P.R. ‘‘Has the applicant ever been convicted
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![61680 Federal Register / Vol. 83, No. 231 / Friday, November 30, 2018 / Notices
of a crime in connection with controlled question. Government’s Motion, GE–1, Weinstock v. United States, 231 F.2d
substance(s) under state or federal law, at 1; Government’s Motion, GE–11, at 1. 699, 701–02 (D.C. Cir. 1956) (other
or been excluded or directed to be Again, the HHS/OIG Exclusion letter citation omitted)). The Court explicitly
excluded from participation in a makes it clear that Respondent knew or addressed what has ‘‘never been the test
medicare or state health care program, should have known that his ‘‘no’’ of materiality[—] that the
or [is] any such action pending?’’ response to this question was false. misrepresentation or concealment
Government’s Motion, GE–1, at 2; Government’s Motion, GE–4, at 1–2. would more likely than not have
Government’s Motion, GE–10, at 1. The second liability question that produced an erroneous decision, or
Respondent answered ‘‘no’’ to this Respondent answered on his online even that it would more likely than not
question. Government’s Motion, GE–1, DEA renewal application asks: ‘‘Has the have triggered an investigation.’’
at 2; Government’s Motion, GE–10, at 1. applicant ever surrendered (for cause) or Kungys, supra, 485 U.S. at 771
The HHS/OIG Exclusion letter makes it had a federal controlled substance (emphasis in original). Instead, the
clear that Respondent knew or should registration revoked, suspended, Court articulated the specific test as
have known that his ‘‘no’’ response to restricted or denied, or is any such ‘‘whether the misrepresentation or
this question was false. Government’s action pending?’’ Government’s Motion, concealment was predictably capable of
Motion, GE–4, at 1–2. GE–l, at 1; Government’s Motion, GE– affecting, i.e., had a natural tendency to
The second liability question that 11, at 1. Respondent answered ‘‘no’’ to affect, the official decision.’’ Id.
Respondent answered on his online this question. Government’s Motion, As already discussed, when
DEA application for a registration asks: GE–1, at 1; Government’s Motion, GE– Respondent submitted an online DEA
‘‘Has the applicant ever surrendered (for 11, at 1. Again, the DEA–104 Voluntary application for a registration and an
cause) or had a federal controlled Surrender of Controlled Substances online DEA renewal application, he
substance registration revoked, Privileges form that Respondent signed answered ‘‘no’’ to whether he had ever
suspended, restricted or denied, or is makes it clear that Respondent knew or been excluded from participation in
any such action pending?’’ should have known that his ‘‘no’’ Medicare and to whether he had ever
Government’s Motion, GE–l, at 2; response to this question was false. surrendered a registration for cause. As
Government’s Motion, GE–10, at 1. Government’s Motion, GE–8, at 1. I already found above, Respondent’s
Respondent answered ‘‘no’’ to this DEA approved Respondent’s renewal four answers were false and he ‘‘knew
question. Government’s Motion, GE–1, application on April 19, 2017. or should have known’’ that they were
at 2; Government’s Motion, GE–10, at 1. Government’s Motion, GE–1, at 1. false.
The DEA–104 Voluntary Surrender of In sum, Respondent is currently I next determine the ‘‘materiality’’ of
Controlled Substances Privileges form registered as a practitioner in schedules Respondent’s four answers. 21 U.S.C.
that Respondent signed, however, II through V under DEA Certificate of 824(a)(1). Concerning Respondent’s
makes it clear that Respondent knew or Registration FR4900305 at Calle false statements about his voluntary
should have known that his ‘‘no’’ Fernandez Garcia 306, Luquillo, Puerto surrender of DEA registration No.
response to this question was false. Rico 00773. Government’s Motion, GE– BR3465944, the DEA–104 that
Government’s Motion, GE–8, at 1. 1, at 1. Respondent’s registration expires Respondent executed does not indicate
DEA approved Respondent’s on April 30, 2020. Id. the underlying reason(s) for
application and, on October 17, 2014, Respondent’s ‘‘alleged failure to comply
assigned DEA Certificate of Registration Discussion with the Federal requirements
No. FR4900305 to him. Government’s The Material Falsification Allegation pertaining to controlled substances.’’
Motion, GE–1, at 1. Government’s Motion, GE–8, at 1.
On April 17, 2017, Respondent Pursuant to 21 U.S.C. 824(a)(1), the Further, as the ALJ noted, the DEA–104
submitted an online DEA renewal Attorney General may suspend or reveals nothing about whether
application for his DEA registration No. revoke a registration issued under Respondent’s ‘‘alleged failure’’ ‘‘had a
FR4900305. Government’s Motion, GE– section 823 of Title 21, ‘‘upon a finding natural tendency to affect’’ an Agency
1, at 1; Government’s Motion, GE–11 that the registrant . . . has materially decision. R.D., at 13–14 (quoting Michel
(Respondent’s DEA Form 224A falsified any application filed pursuant P. Toret, M.D., 82 FR 60,041, 60,043
submitted on April 17, 2017), at 1. The to or required by this subchapter.’’ (2017) quoting Kungys, supra, 485 U.S.
online DEA renewal application According to Agency precedent, the at 771). I found no evidence in the
Respondent submitted includes ‘‘yes’’ or Government must show that a record concerning the materiality of
‘‘no’’ liability questions that an respondent ‘‘knew or should have Respondent’s two false answers about
applicant must answer to advance to the known’’ that his response to a liability his voluntary surrender. Thus, I agree
next page of the online DEA renewal question was false. Samuel S. Jackson, with the ALJ that the record does not
application. Government’s Motion, GE– D.D.S., 72 FR 23,848, 23,852 (2007). support a finding that Respondent’s two
l, at 1; Government’s Motion, GE–11, at Also according to Agency precedent, a false answers about his voluntary
1. respondent’s claim that he surrender of registration No. BR3465944
The first liability question that misunderstood a liability question is not were ‘‘materially’’ false. 21 U.S.C.
Respondent answered on his online a defense. Alvin Darby, M.D., 75 FR 824(a)(1).
DEA renewal application asks: ‘‘Has the 26,993, 26,999 (2010). Concerning Respondent’s false
applicant ever been convicted of a crime According to the Supreme Court, statements regarding his mandatory
in connection with controlled Federal courts’ ‘‘most common exclusion, the Agency has never before
substance(s) under state or federal law, formulation’’ of the concept of considered the materiality of a
amozie on DSK3GDR082PROD with NOTICES1
or been excluded or directed to be ‘‘materiality’’ is that ‘‘a concealment or respondent’s false answers about his
excluded from participation in a misrepresentation is material if it ‘has a mandatory exclusion as that question is
medicare or state health care program, natural tendency to influence, or was posed in this case. I find the ALJ’s
or [is] any such action pending?’’ capable of influencing, the decision of’ analysis persuasive: ‘‘Considering that
Government’s Motion, GE–1, at 1; the decisionmaking body to which it exclusion from a federal health care
Government’s Motion, GE–11, at 1. was addressed.’’ Kungys v. United program under 42 U.S.C. 1320a–7(a) is
Respondent answered ‘‘no’’ to this States, 485 U.S. 759, 770 (1988) (quoting an independent basis for revoking [a]
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![Federal Register / Vol. 83, No. 231 / Friday, November 30, 2018 / Notices 61681
registration . . ., it is reasonable to capacity in Medicare, Medicaid, and all Respondent’s DEA registration be
conclude that information regarding an Federal health care programs and that revoked and that any pending
applicant’s mandatory exclusion by Respondent is still excluded from application of Respondent to renew or
HHS would be ‘capable of influencing participation in these programs. to modify that registration be denied.
the [DEA’s] decision.’ ’’ R.D., at 13 Accordingly, I find that the evidence in
Order
(citations omitted). I agree with the ALJ. the record satisfies the Government’s
I find that Respondent’s failure to prima facie burden to support the Pursuant to 28 CFR 0.100(b) and the
disclose his mandatory exclusion from a revocation of Respondent’s registration authority thus vested in me by 21 U.S.C.
Federal health care program is material. under 21 U.S.C. 824(a)(5). 824(a), I order that DEA Certificate of
Id. Thus, I find that there is substantial Registration No. FR4900305 issued to
Sanction Narciso A. Reyes, M.D., be, and it
evidence in the record that Respondent
materially falsified a DEA registration Where, as here, the Government has hereby is, revoked. Pursuant to 28 CFR
application and a DEA registration met its prima facie burden, the burden 0.100(b) and the authority thus vested in
renewal application concerning his shifts to Respondent to show why he me by 21 U.S.C. 823(f), I further order
mandatory exclusion. 21 U.S.C. can be entrusted with a registration. that any pending application of Narciso
824(a)(1). Respondent, however, did not submit A. Reyes, M.D., to renew or to modify
evidence for the record. Instead, he this registration, be, and it hereby is,
The Allegation of Mandatory Exclusion stated that the documents are self- denied. This Order is effective
From a Federal Health Care Program explanatory, that he ‘‘will not make any December 31, 2018.
Pursuant to 21 U.S.C. 824(a)(5), the statement regarding this administrative
Dated: November 19, 2018.
Attorney General may suspend or action,’’ and that ‘‘[t]he issue is hereby
revoke a registration issued under submitted for final ruling.’’ R.D., at 7. Uttam Dhillon,
section 823 of Title 21, ‘‘upon a finding Thus, the question now is whether Acting Administrator.
that the registrant . . . has been revocation is the appropriate sanction [FR Doc. 2018–26047 Filed 11–29–18; 8:45 am]
excluded . . . from participation in a under the facts I have found: Two BILLING CODE 4410–09–P
program pursuant to section 1320a–7(a) separate violations whose statutory
of Title 42.’’ Agency precedent makes sanctions include revocation. 21 U.S.C.
clear that revocation under 21 U.S.C. 824(a)(1) and (5). DEPARTMENT OF JUSTICE
824(a)(5) may be appropriate regardless I agree with the ALJ’s analysis and
of whether or not the misconduct that conclude that revocation is Office of Justice Programs
led to the mandatory exclusion involved independently the appropriate sanction [OJP (OJJDP) Docket No. 1752]
controlled substances. KK Pharmacy, 64 for each of the separate violations the
FR 49,507, 49,510 (1999) (collecting facts support. In particular, I agree with Meeting of the Coordinating Council
cases) (The Agency ‘‘has previously the ALJ’s analysis that, even though the on Juvenile Justice and Delinquency
held that misconduct which does not underlying misconduct which led to Prevention
involve controlled substances may Respondent’s conviction and mandatory
AGENCY: Coordinating Council on
constitute grounds, under 21 U.S.C. exclusion did not involve controlled
Juvenile Justice and Delinquency
824(a)(5), for the revocation of a DEA substances, it did involve the unlawful
Prevention, Office of Justice Programs,
Certificate of Registration.’’); Melvin N. use of Respondent’s prescribing
Department of Justice.
Seglin, M.D., 63 FR 70,431, 70,433 authority. R.D., at 17. As the ALJ stated,
‘‘This type of fraudulent behavior does ACTION: Notice of meeting.
(1998) (‘‘[M]isconduct which does not
involve controlled substances may not inspire confidence that . . . SUMMARY: The Coordinating Council on
constitute grounds for the revocation of [Respondent] can be trusted with a Juvenile Justice and Delinquency
a DEA registration pursuant to 21 U.S.C. prescription pad bearing a DEA Prevention announces its next meeting.
824(a)(5).’’); Stanley Dubin, D.D.S., 61 registration number.’’ Id. After all, if
DATES: Wednesday, December 19, 2018
FR 60,727, 60,728 (1996) (Registration Respondent signed blank certificates of
at 10 a.m. EST.
revoked and pending applications for medical necessity for durable medical
ADDRESSES: The meeting will take place
renewal denied when registrant’s equipment that was not medically
‘‘actions cast substantial doubt on . . . necessary, ‘‘it is doubtful that DEA can in the third floor main conference room
[his] integrity.’’); George D. Osafo, M.D., expect . . . [Respondent] to honestly at the U.S. Department of Justice, Office
58 FR 37,508, 37,509 (1993) prescribe controlled substances for only of Justice Programs, 810 7th St. NW,
(Submission of fraudulent medical legitimate medical purposes.’’ Id. Washington, DC 20531.
claims and larceny convictions Further, Respondent materially FOR FURTHER INFORMATION CONTACT: Visit
indicated that registrant ‘‘placed falsified two DEA applications. One the website for the Coordinating Council
monetary gain above the welfare of his such falsification, alone, is sufficient, at www.juvenilecouncil.gov or contact
patients, and in so doing, endangered without proof of any other misconduct, Jeff Slowikowski, Designated Federal
the public health and safety.’’). to revoke a registration. Toret, supra, 82 Official (DFO), OJJDP, by telephone at
Under 42 U.S.C. 1320a–7(a)(1), the FR at 60,043. As the ALJ stated, ‘‘[N]ot (202) 616–3646, email at
HHS OIG is required to exclude from only has the Government proven two jeff.slowikowski@usdoj.gov, or fax at
participation in any Federal health care independent bases for revoking . . . (202) 353–9093; or Sarah Wisniewski,
program any individual who has been [Respondent’s] registration . . ., but Senior Program Manager/Federal
convicted of a criminal offense ‘‘related . . . [Respondent] has not advanced any Contractor, by telephone (202) 305–
amozie on DSK3GDR082PROD with NOTICES1
to the delivery of an item or service evidence that he ‘can be trusted to 9017, email at sarah.wisniewski@
under . . . [42 U.S.C. 1395 et seq.] or responsibly discharge his obligations as usdoj.gov, or fax at (866) 854–6619.
under any State health care program.’’ a registrant.’ ’’ R.D., at 17–18 (citation Please note that the above phone/fax
Based on the uncontroverted evidence omitted). numbers are not toll free.
in the record, as already discussed, I Accordingly, based on the evidence in SUPPLEMENTARY INFORMATION: The
found that Respondent has been the record supporting two independent Coordinating Council on Juvenile
excluded from participation in any bases for revocation, I shall order that Justice and Delinquency Prevention
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Document Created: 2018-11-30 04:35:41
Document Modified: 2018-11-30 04:35:41
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