Notice2025-13313

Sasha Melissa Ikramelahai; Decision and Order

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Published
July 16, 2025

Issuing agencies

Justice DepartmentDrug Enforcement Administration

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<title>Federal Register, Volume 90 Issue 134 (Wednesday, July 16, 2025)</title>
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[Federal Register Volume 90, Number 134 (Wednesday, July 16, 2025)]
[Notices]
[Pages 32017-32021]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-13313]


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DEPARTMENT OF JUSTICE

Drug Enforcement Administration


Sasha Melissa Ikramelahai; Decision and Order

    On January 22, 2025, the Drug Enforcement Administration (DEA or 
Government) issued an Order to Show Cause (OSC) to Sasha Melissa 
Ikramelahai of Southern Pines, North Carolina (Registrant). Request for 
Final Agency Action (RFAA), Exhibit (RFAAX) 1, at 1, 5. The OSC 
proposed the revocation of Registrant's DEA registration, No. 
MI8411061, alleging that she currently lacks state authority to handle 
controlled substances in North Carolina and that she materially 
falsified her application for registration. Id. (citing 21 U.S.C. 
824(a)(1), 824(a)(3)).
    On March 27, 2025, the Government submitted an RFAA to the 
Administrator requesting that the Agency issue a default final order 
revoking Registrant's registration. RFAA, at 1, 3, 6-7. After carefully 
reviewing the entire record and conducting the analysis as set forth in 
detail below, the Agency finds that Registrant is in default, finds 
that Registrant is without state authority, and finds that Registrant 
materially falsified her application. Accordingly, the Agency grants 
the Government's RFAA and revokes Registrant's registration.

I. Default Determination

    Under 21 CFR 1301.43, a registrant entitled to a hearing who fails 
to file a timely hearing request ``within 30 days after the date of 
receipt of the [OSC] . . . shall be deemed to have waived their right 
to a hearing and to be in default'' unless ``good cause'' is 
established for the failure. 21 CFR 1301.43(a), (c)(1). In the absence 
of a demonstration of good cause, a registrant who fails to timely file 
an answer also is ``deemed to have waived their right to a hearing and 
to be in default.'' 21 CFR 1301.43(c)(2). Unless excused, a default 
constitutes ``an admission of the factual allegations of the [OSC].'' 
21 CFR 1301.43(e).
    The OSC notified Registrant of her right to file a written request 
for hearing and answer, and that if she failed to file such a request 
and answer, she would be deemed to have waived her right to a hearing 
and be in default.\1\ RFAAX 1,

[[Page 32018]]

at 3-4 (citing 21 CFR 1301.43). Here, Registrant did not request a 
hearing, file an answer, or respond to the OSC in any way. RFAA, at 1-
2, 6. Accordingly, Registrant is in default. 21 CFR 1301.43(c)(1); 
RFAA, at 1, 3, 6.
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    \1\ Based on the Government's submissions in its RFAA dated 
March 27, 2025, the Agency finds that service of the OSC on 
Registrant was adequate. Specifically, the Declaration from a DEA 
Diversion Investigator (DI) indicates that on January 24, 2025, DIs 
attempted to serve the OSC on Registrant at her home address. RFAAX 
2, at 1. The DIs were met by Registrant's mother, who told them that 
Registrant did not live at that address. Id. On January 27, 2025, DI 
attempted to serve the OSC to several email addresses associated 
with Registrant. Id. at 2. Service by email was successful as DI 
received an email delivery receipt from Registrant's registered 
email address. Id. Additionally, on February 6, 2025, DI attempted 
to serve the OSC on Registrant by USPS Certified Mail at her 
registered address, but the mail was returned to sender. Id. On 
February 7, 2025, DI attempted to reach Registrant by phone at her 
registered employer, but was told by the clinic's CEO that she no 
longer worked there. Id. Based on these multiple attempts at service 
that were ``reasonably calculated'' to notify her of the OSC, and 
the fact that DI received an email delivery receipt from 
Registrant's registered email address, the Agency finds that due 
process notice requirements have been satisfied. See Jones v. 
Flowers, 547 U.S. 220, 226 (2006) (quoting Mullane v. Cent. Hanover 
Bank & Trust Co., 339 U.S. 306, 314 (1950)); Mohammed S. Aljanaby, 
M.D., 82 FR 34,552, 34,552 (2017) (finding that service by email 
satisfies due process where the email is not returned as 
undeliverable and other methods have been unsuccessful); Emilio 
Luna, M.D., 77 FR 4,829, 4,830 (2012) (concluding that ``the use of 
email to serve Registrant satisfied due process because service was 
made to an email address which Registrant provided to the Agency and 
the Government did not receive back either an error or undeliverable 
message'').
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    ``A default, unless excused, shall be deemed to constitute a waiver 
of the [registrant's] right to a hearing and an admission of the 
factual allegations of the [OSC].'' 21 CFR 1301.43(e). Because 
Registrant is in default and has not moved to excuse the default, the 
Agency finds that Registrant has admitted to the factual allegations in 
the OSC. 21 CFR 1301.43(c)(1), (e), (f)(1).
    Further, ``[i]n the event that [a registrant] . . . is deemed to be 
in default . . . DEA may then file a request for final agency action 
with the Administrator, along with a record to support its request. In 
such circumstances, the Administrator may enter a default final order 
pursuant to [21 CFR] 1316.67.'' 21 CFR 1301.43(f)(1). Here, the 
Government has requested final agency action based on Registrant's 
default pursuant to 21 CFR 1301.43(c), (f), and 1301.46. RFAA, at 1, 3, 
6; see also 21 CFR 1316.67.

II. Lack of State Authority

A. Findings of Fact

    The Agency finds that, in light of Registrant's default, the 
factual allegations in the OSC are deemed admitted. 21 CFR 1301.43(e). 
Accordingly, Registrant is deemed to have admitted, in accordance with 
the OSC, that on July 9, 2024, the North Carolina Medical Board (NCMB) 
annulled Registrant's physician assistant license. RFAAX 1, at 3. 
Specifically, the NCMB annulled Registrant's physician assistant 
license based on findings that (a) she engaged in immoral or 
dishonorable conduct; (b) made false statements or representations to 
the NCMB; (c) engaged in unprofessional conduct by fraudulently 
obtaining and using the identity, credentials, experience, and 
licensing information of someone else in false representations and 
forged documents; and (d) obtained or attempted to obtain a practice, 
money, or anything of value by false representations. Id.
    According to North Carolina online records, of which the Agency 
takes official notice, Registrant's physician assistant license is in 
an ``Inactive'' status.\2\ North Carolina Medical Board License 
Verification Search, <a href="https://portal.ncmedboard.org/verification/search.aspx">https://portal.ncmedboard.org/verification/search.aspx</a> (last visited date of signature of this Order). 
Accordingly, the Agency finds that Registrant is not licensed as a 
physician assistant in North Carolina, the state in which she is 
registered with DEA.\3\
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    \2\ Under the Administrative Procedure Act, an agency ``may take 
official notice of facts at any stage in a proceeding--even in the 
final decision.'' United States Department of Justice, Attorney 
General's Manual on the Administrative Procedure Act 80 (1947) (Wm. 
W. Gaunt & Sons, Inc., Reprint 1979).
    \3\ Pursuant to 5 U.S.C. 556(e), ``[w]hen an agency decision 
rests on official notice of a material fact not appearing in the 
evidence in the record, a party is entitled, on timely request, to 
an opportunity to show the contrary.'' The material fact here is 
that Registrant, as of the date of this Decision and Order, is not 
licensed to practice as a physician assistant in North Carolina. 
Accordingly, Registrant may dispute the Agency's finding by filing a 
properly supported motion for reconsideration of findings of fact 
within fifteen calendar days of the date of this Order. Any such 
motion and response shall be filed and served by email to the other 
party and to the DEA Office of the Administrator, Drug Enforcement 
Administration, at <a href="/cdn-cgi/l/email-protection#187c7d7936797c7c7736796c6c776a767d616b587c7d79367f776e"><span class="__cf_email__" data-cfemail="d7b3b2b6f9b6b3b3b8f9b6a3a3b8a5b9b2aea497b3b2b6f9b0b8a1">[email&#160;protected]</span></a>.
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B. Discussion

    Pursuant to 21 U.S.C. 824(a)(3), the Attorney General may suspend 
or revoke a registration issued under 21 U.S.C. 823 ``upon a finding 
that the registrant . . . has had his State license or registration 
suspended . . . [or] revoked . . . by competent State authority and is 
no longer authorized by State law to engage in the . . . dispensing of 
controlled substances.'' With respect to a practitioner, DEA has also 
long held that the possession of authority to dispense controlled 
substances under the laws of the state in which a practitioner engages 
in professional practice is a fundamental condition for obtaining and 
maintaining a practitioner's registration. Gonzales v. Oregon, 546 U.S. 
243, 270 (2006) (``The Attorney General can register a physician to 
dispense controlled substances `if the applicant is authorized to 
dispense . . . controlled substances under the laws of the State in 
which he practices.' . . . The very definition of a `practitioner' 
eligible to prescribe includes physicians `licensed, registered, or 
otherwise permitted, by the United States or the jurisdiction in which 
he practices' to dispense controlled substances. [21 U.S.C.] 
802(21).''). The Agency has applied these principles consistently. See, 
e.g., James L. Hooper, M.D., 76 FR 71,371, 71,372 (2011), pet. for rev. 
denied, 481 F. App'x 826 (4th Cir. 2012); Frederick Marsh Blanton, 
M.D., 43 FR 27,616, 27,617 (1978).\4\
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    \4\ This rule derives from the text of two provisions of the 
Controlled Substances Act (CSA). First, Congress defined the term 
``practitioner'' to mean ``a physician . . . or other person 
licensed, registered, or otherwise permitted, by . . . the 
jurisdiction in which he practices . . . , to distribute, dispense, 
. . . [or] administer . . . a controlled substance in the course of 
professional practice.'' 21 U.S.C. 802(21). Second, in setting the 
requirements for obtaining a practitioner's registration, Congress 
directed that ``[t]he Attorney General shall register practitioners 
. . . if the applicant is authorized to dispense . . . controlled 
substances under the laws of the State in which he practices.'' 21 
U.S.C. 823(g)(1). Because Congress has clearly mandated that a 
practitioner possess state authority in order to be deemed a 
practitioner under the CSA, DEA has held repeatedly that revocation 
of a practitioner's registration is the appropriate sanction 
whenever he is no longer authorized to dispense controlled 
substances under the laws of the state in which he practices. See, 
e.g., Hooper, 76 FR at 71,371-72; Sheran Arden Yeats, M.D., 71 FR 
39,130, 39,131 (2006); Dominick A. Ricci, M.D., 58 FR 51,104, 51,105 
(1993); Bobby Watts, M.D., 53 FR 11,919, 11,920 (1988); Blanton, 43 
FR at 27,617.
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    According to North Carolina statute, ``dispense'' means ``to 
deliver a controlled substance to an ultimate user or research subject 
by or pursuant to the lawful order of a practitioner, including the 
prescribing, administering, packaging, labeling, or compounding 
necessary to prepare the substance for that delivery.'' N.C. Gen. Stat. 
Ann. Sec.  90-87(8) (West 2025). Further, a ``practitioner'' means a 
``physician . . . or other person licensed, registered or otherwise 
permitted to distribute, dispense, conduct research with respect to or 
to administer a controlled substance so long as such activity is within 
the normal course of professional practice or research in this State.'' 
Id. at Sec.  90-87(22)(a).
    Here, the undisputed evidence in the record is that Registrant 
lacks authority to practice as a physician assistant in North Carolina. 
As discussed above, an individual must be a licensed practitioner to 
dispense a controlled substance in North Carolina. Thus, because 
Registrant lacks authority to

[[Page 32019]]

practice as a physician assistant in North Carolina and, therefore, is 
not authorized to handle controlled substances in North Carolina, 
Registrant is not eligible to maintain a DEA registration in that 
state. Accordingly, the Agency will order that Registrant's DEA 
registration be revoked.

III. Material Falsification

A. Findings of Fact

    The Agency finds that, in light of Registrant's default, the 
factual allegations in the OSC are deemed admitted. 21 CFR 1301.43(e). 
Accordingly, Registrant is deemed to have admitted to each of the 
following facts. On October 27, 2023, Registrant applied for DEA 
registration as a mid-level practitioner, physician assistant, in 
Schedules II through V. RFAAX 1, at 2. On October 30, 2023, Registrant 
was granted DEA registration No. MI8411061. Id.
    Prior to applying for DEA registration, Registrant fraudulently 
used the identity and credentials of another physician assistant to 
obtain her own North Carolina physician assistant license. Id. Her 
North Carolina physician assistant license, which she obtained by 
fraud, was used as a basis for establishing the required state 
authority to procure her DEA registration. Id. at 2-3.
    When Registrant applied for DEA registration, the application 
requested information regarding the medical/professional school that 
she attended and the year she graduated. Id. at 2. Registrant responded 
by stating that she graduated in 2014 from the University of New 
Mexico, facts that were true of the other physician assistant whose 
identity Registrant had assumed, but not of Registrant. Id.
    The application also asked: ``Have you graduated, in good standing, 
from an accredited school of . . . physician assistant . . . in the 
United States during the 5-year period immediately preceding the date 
on which you first submitted a registration or renewal and the 
curriculum included not less than 8 hours of training?'' Id. Registrant 
answered ``yes'' to this question. Id.
    By signing the application for registration, Registrant represented 
that the following statement contained on the DEA application was true 
in regards to her state authority to practice as a physician assistant 
in North Carolina: ``You must be currently authorized to prescribe, 
distribute, dispense, conduct research, or otherwise handle the 
controlled substances in the schedules for which you are applying under 
the laws of the state or jurisdiction in which you are operating or 
propose to operate.'' Id. at 3.

B. Discussion

    A DEA registration may be denied, suspended, or revoked upon a 
finding that the applicant or registrant materially falsified any 
application filed pursuant to or required by the Controlled Substances 
Act (CSA). 21 U.S.C. 824(a)(1).\5\ To present a prima facie case for 
material falsification, the Government's record evidence must show (1) 
the submission of an application, (2) containing a false statement and/
or omitting information that the application requires, (3) when the 
submitter knew or should have known that the statement is false and/or 
that the omitted information existed and the application required its 
disclosure, and (4) the false statement and/or required but omitted 
information is material, that is, it ``connect[s] to at least one of 
[the section 823] factors that, according to the CSA, [the 
Administrator] `shall' consider'' when analyzing ``whether issuing a 
registration `would be inconsistent with the public interest.''' Frank 
Joseph Stirlacci, M.D., 85 FR 45,229, 45,238 (2020) (citing 21 U.S.C. 
823 and Kungys, 485 U.S. at 771). The Government must establish 
material falsification with record evidence that is clear, unequivocal, 
and convincing. Kungys, 485 U.S. at 772; Stirlacci, 85 FR at 45,230-39.
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    \5\ A statutory basis to deny an application pursuant to section 
823 is also a basis to revoke or suspend a registration pursuant to 
section 824, and vice versa, because doing ``otherwise would mean 
that all applications would have to be granted only to be revoked 
the next day . . . .'' Robert Wayne Locklear, M.D., 86 FR 33,738, 
33,744-45 (2021) (collecting cases).
     The Supreme Court's decision in Kungys v. United States, 485 
U.S. 759 (1988), and its progeny, guide the Agency's implementation 
of these CSA provisions.
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    First, the Government must prove that the applicant or registrant 
submitted an application for registration pursuant to the CSA. 21 
U.S.C. 824(a)(1); see also 21 U.S.C. 822 (persons required to 
register); 21 U.S.C. 823(g)(1) (registration requirements).
    Second, the Government must prove that the application contained a 
false statement or omitted information that the application required, 
either of which may constitute a material falsity. See, e.g., Emed 
Medical Company LLC and Med Assist Pharmacy, 88 FR 21,719, 21,720 
(2023) (applicant falsely answered ``no'' to Liability Question 3 on 
seventeen applications when the true answer was ``yes''); Richard J. 
Settles, D.O., 81 FR 64,940, 64,945-46 (2016) (applicant failed to 
disclose an interim consent agreement restricting his license based on 
findings that he issued controlled substance prescriptions without 
federal or state legal authority to do so). In making this assessment, 
the Agency will examine the entire application, including registrant's 
``yes/no'' answers to the liability questions and any follow-up 
response(s). Daniel A. Glick, D.D.S., 80 FR 74,800, 74,802, 74,808-09 
(2015). To establish an omission, the Government must show both that 
omitted information existed and that the application required inclusion 
of that information. See, e.g., Richard A. Herbert, M.D., 76 FR 53,942, 
53,956 (2011) (omission of a probation which the application required 
to be identified); Michel P. Toret, M.D., 82 FR 60,041, 60,042 (2017) 
(Voluntary Surrender Form alone is insufficient evidence to find 
material falsification based on registrant's ``no'' answer to the 
question regarding ``surrender[s] (for cause)'').
    Third, the Government must prove that the applicant or registrant 
knew or should have known that the statement is false and/or that the 
omitted information existed and the application required its 
disclosure. See John J. Cienki, M.D., 63 FR 52,293, 52,295 (1998) 
(``[I]n finding that there has been a material falsification of an 
application, it must be determined that the applicant knew or should 
have known that the response given to the liability question was 
false.''); Samuel Arnold, D.D.S., 63 FR 8,687, 8,688 (1998) (``It is 
also undisputed that Respondent knew that his Ohio dental license had 
previously been suspended.''); Bobby Watts, M.D., 58 FR 46,995, 46,995 
(1993) (``Respondent knew that the Tennessee Board of Medical Examiners 
had suspended his medical license on May 7, 1987, and had placed his 
state medical license on probation on May 2, 1988.''); see also 
Stirlacci, 85 FR at 45,236-37 & nn.22-23 (collecting cases).
    Fourth, the Government must prove that the false statement and/or 
required but omitted information is ``material.'' Kungys holds that a 
statement is material if it is ``predictably capable of affecting, 
i.e., had a natural tendency to affect, the [Agency's] official 
decision,'' or stated differently, ``had a natural tendency to 
influence the decision.'' Kungys, 485 U.S. at 771-72. As already 
discussed, materiality, for the purposes of the CSA, is tied to the 
factors that the Administrator ``shall'' consider when determining 
whether issuance of a registration ``would be inconsistent with the 
public interest.'' 21 U.S.C. 823; Kungys, 485 U.S. at 771-72; 
Stirlacci, 85 FR at 45,234, 45,238.

[[Page 32020]]

    The Government has the burden of proof in this proceeding. 21 CFR 
1301.44. After evaluating each of the alleged material falsifications, 
the Agency finds that the Government's record evidence presents a prima 
facie case that Registrant submitted a materially false application. 21 
U.S.C. 823, 824(a)(1).
    Here, there is no question that Registrant submitted an application 
for DEA registration and that the application contained multiple 
falsities. RFAAX 1, at 2-3. Two such falsities were that Registrant, 
assuming the identity of a properly licensed practitioner, represented 
that she attended the University of New Mexico for professional school 
and graduated in 2014. Id. at 2. Registrant, through her signature, 
also represented that she was ``currently authorized to prescribe, 
distribute, dispense, conduct research, or otherwise handle the 
controlled substances in the schedules for which [she was] applying 
under the laws of the state or jurisdiction in which [she was] 
operating or propos[ed] to operate.'' Id. at 3.
    But Registrant's state authorization to handle controlled 
substances was not obtained pursuant to law--it was obtained by fraud. 
Registrant, in assuming someone else's identity, certainly knew or 
should have known that she had not graduated from the University of New 
Mexico in 2014 as she represented to the NCMB and to DEA. Indeed, the 
NCMB later found that Registrant's state physician assistant license 
had been acquired under false pretenses as a result of Registrant 
representing herself as someone else. Id. Accordingly, the NCMB 
annulled the license it had issued to Registrant under false pretenses. 
Id. Thus, Registrant falsified her DEA application by representing that 
she was authorized to handle controlled substances ``under the laws 
of'' North Carolina when she would not have been granted state 
authority were it not for her fraud. Id.
    In addition, the falsification was material. The Agency has 
consistently held for decades that possessing valid state authority to 
handle controlled substances is a prerequisite for obtaining a DEA 
registration.\6\ Thus, whether an applicant possesses valid state 
authority to handle controlled substances in the state for which the 
applicant seeks registration is a critical factor DEA must consider 
when reviewing an application.\7\
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    \6\ See Joely Keen, A.P.R.N., 90 FR 13,882, 13,883 (2025) (``DEA 
has . . . long held that the possession of authority to dispense 
controlled substances under the laws of the state in which a 
practitioner engages in professional practice is a fundamental 
condition for obtaining and maintaining a practitioner's 
registration.''); Blanton, 43 FR at 27,617 (holding that ``[s]tate 
authorization to dispense or otherwise handle controlled substances 
is a prerequisite to'' obtaining and maintaining a DEA 
registration).
    \7\ See 21 U.S.C. 802(21) (defining a ``practitioner'' as one 
who is ``licensed, registered, or otherwise permitted, by . . . the 
jurisdiction in which he practices'' to handle controlled substances 
``in the course of professional practice''); 21 U.S.C. 823(g)(1) 
(``The Attorney General shall register practitioners . . . if the 
applicant is authorized to dispense . . . controlled substances 
under the laws of the State in which he practices.''); 21 U.S.C. 
824(a)(3) (providing a basis for revoking a registration where the 
registrant lacks the requisite state authority to dispense 
controlled substances); Gonzales v. Oregon, 546 U.S. 243, 270 (2006) 
(``The structure and operation of the CSA presume and rely upon a 
functioning medical profession regulated under the States' police 
powers'' and explaining registration requirements and the definition 
of ``practitioner''); Hatem M. Ataya, M.D., 81 FR 8,221, 8,244 
(2016) (explaining ``the possession of state authority is a 
prerequisite for obtaining a registration''); Hoi Y. Kam, M.D., 78 
FR 62,694, 62,696 (2013) (``Because possessing authority to dispense 
controlled substances under the laws of the State in which a 
physician practices medicine is a requirement for holding a DEA 
registration, . . . a false answer to the state license question is 
material where an applicant no longer holds authority to practice 
medicine (regardless of the reason for the State's action) or 
authority to dispense controlled substances . . . .'') (emphasis 
added).
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    In Steven Bernhard, D.O., the Agency found that an application was 
materially false where the applicant falsely represented that he 
possessed valid state authority to handle controlled substances, when 
in fact, he did not. 82 FR 23,298, 23,300 (2017). The Agency explained 
that ``[b]ecause the possession of state authority is a prerequisite to 
obtaining and maintaining a practitioner's registration, Respondent's 
false representations that he currently possessed a state license . . . 
[was] capable of influencing the Agency's decision to grant his . . . 
application.'' Id.; see also Thomas G. Easter II, M.D., 69 FR 5,579, 
5,580 (2004) (finding that applicant materially falsified an 
application for registration by falsely representing that ``he was 
`currently authorized to prescribe' controlled substances `under the 
laws of the State or jurisdiction in which [he was] operating or 
propos[ed] to operate' '').
    Thus, Registrant's application representing that she possessed 
state authorization obtained pursuant to law to handle controlled 
substances directly affected the statutory analysis that DEA was 
required to make when it reviewed Registrant's application. 21 U.S.C. 
802(21), 823(g)(1), 824(a)(3); Gonzales, 546 U.S. at 270; Stirlacci, 85 
FR at 45,238; Bernhard, 82 FR at 23,300; Easter, 69 FR at 5,580. Stated 
differently, Registrant's application led DEA to believe that she 
possessed valid state authority when, in fact, that state authority was 
invalid under state law as it had been obtained by fraud. RFAAX 1, at 
2-3; Bernhard, 82 FR at 23,300; Easter, 69 FR at 5,580. Thus, her false 
representation was material because it was ``predictably capable of 
affecting . . . [DEA's] official decision'' regarding whether 
Registrant met ``the requirements for'' registration. Kungys, 485 U.S. 
at 771.
    In sum, the Agency finds clear, unequivocal, and convincing record 
evidence, and Registrant is deemed to have admitted, that she submitted 
a materially false application for registration. 21 U.S.C. 824(a)(1); 
21 CFR 1301.43(e).
    As a result of this established violation, the Agency finds that 
the Government has established a prima facie case for sanction, that 
Registrant did not rebut that prima facie case, and that there is 
substantial record evidence supporting the revocation of Registrant's 
registration. 21 U.S.C. 824(a)(1).

C. Sanction

    Where, as here, the Government has presented a prima facie case 
showing that a registrant submitted a materially false application for 
registration, the burden shifts to Registrant to show why she can be 
trusted with a registration. Morall v. Drug Enf't Admin., 412 F.3d 165, 
181 (D.C. Cir. 2005); Jones Total Health Care Pharmacy, LLC v. Drug 
Enf't Admin., 881 F.3d 823, 830 (11th Cir. 2018); Garrett Howard Smith, 
M.D., 83 FR 18,882, 18,904 (2018). The issue of trust is a fact-
dependent determination based on the circumstances presented by the 
individual practitioner. Jeffrey Stein, M.D., 84 FR 46,968, 46,972 
(2019); see also Jones Total Health Care Pharmacy, 881 F.3d at 833. 
Historically, the Agency has considered acceptance of responsibility, 
egregiousness, and deterrence when making this assessment.
    Specifically, the Agency requires the practitioner to accept 
responsibility for his or her violation. Jones Total Health Care 
Pharmacy, 881 F.3d at 833; ALRA Labs, Inc. v. Drug Enf't Admin., 54 
F.3d 450, 452 (7th Cir. 1995). Acceptance of responsibility must be 
unequivocal. Janet S. Pettyjohn, D.O., 89 FR 82,639, 82,641 (2024); 
Mohammed Asgar, M.D., 83 FR 29,569, 29,573 (2018); see also Jones Total 
Health Care Pharmacy, 881 F.3d at 830-31.
    In addition, the Agency considers the egregiousness and extent of 
the misconduct in determining the appropriate sanction. Jones Total 
Health Care Pharmacy, 881 F.3d at 834 & n.4. The Agency also considers 
the need to deter similar acts by Registrant and by

[[Page 32021]]

future applicants for registration. Stein, 84 FR at 46,972-73.
    Here, Registrant did not timely request a hearing, or timely or 
properly answer the allegations, and was therefore deemed to be in 
default. 21 CFR 1301.43(c)(1), (e), (f)(1); RFAA, at 1-4. To date, 
Registrant has not filed a motion with the Office of the Administrator 
to excuse the default. 21 CFR 1301.43(c)(1). Registrant has thus failed 
to answer the allegations contained in the OSC and has not otherwise 
availed herself of the opportunity to refute the Government's case. As 
such, Registrant has not accepted responsibility for the proven 
violations, has made no representations regarding her future compliance 
with the CSA, and has not made any demonstration that she can be 
trusted with registration.
    Moreover, the evidence presented by the Government shows that 
Registrant misrepresented her qualifications for registration and used 
another person's identity in order to fraudulently obtain a state 
professional license, further demonstrating that Registrant cannot be 
trusted with the responsibilities of holding a controlled substances 
registration. To permit Registrant to maintain a registration under 
these circumstances would send a dangerous message that identity theft 
and fraud are acceptable means of acquiring a DEA registration and that 
DEA does not require truthfulness from applicants and registrants. 
Accordingly, the Agency will order the revocation of Registrant's 
registration.\8\
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    \8\ In this matter there are two separate and distinct grounds 
by which the Government proposed revocation, Registrant's lack of 
state authority and her material falsification; each ground, 
standing alone, supports the Agency's decision to revoke.
---------------------------------------------------------------------------

Order

    Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21 
U.S.C. 824(a), I hereby revoke DEA Certificate of Registration No. 
MI8411061 issued to Sasha Melissa Ikramelahai. Further, pursuant to 28 
CFR 0.100(b) and the authority vested in me by 21 U.S.C. 823(g)(1), I 
hereby deny any pending applications of Sasha Melissa Ikramelahai to 
renew or modify this registration, as well as any other pending 
application of Sasha Melissa Ikramelahai for additional registration in 
North Carolina. This Order is effective August 15, 2025.

Signing Authority

    This document of the Drug Enforcement Administration was signed on 
July 10, 2025, by Acting Administrator Robert J. Murphy. That document 
with the original signature and date is maintained by DEA. For 
administrative purposes only, and in compliance with requirements of 
the Office of the Federal Register, the undersigned DEA Federal 
Register Liaison Officer has been authorized to sign and submit the 
document in electronic format for publication, as an official document 
of DEA. This administrative process in no way alters the legal effect 
of this document upon publication in the Federal Register.

Heather Achbach,
Federal Register Liaison Officer, Drug Enforcement Administration.
[FR Doc. 2025-13313 Filed 7-15-25; 8:45 am]
BILLING CODE 4410-09-P


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Indexed from Federal Register on July 16, 2025.

This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.