Notice2025-19579

David S. Pecora, P.A.; Decision and Order

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Published
October 17, 2025

Issuing agencies

Justice DepartmentDrug Enforcement Administration

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<title>Federal Register, Volume 90 Issue 199 (Friday, October 17, 2025)</title>
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[Federal Register Volume 90, Number 199 (Friday, October 17, 2025)]
[Notices]
[Pages 48357-48364]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-19579]


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DEPARTMENT OF JUSTICE

Drug Enforcement Administration


David S. Pecora, P.A.; Decision and Order

    On August 16, 2024, the Drug Enforcement Administration (DEA or 
Government) issued an Order to Show Cause (OSC) to David S. Pecora, 
P.A., of Bemidji, Minnesota (Applicant). Request for Final Agency 
Action (RFAA), Exhibit (RFAAX) 1, at 1, 15. The OSC proposed the denial 
of Applicant's application for DEA registration, Control Number 
W23054133M, alleging that he materially falsified multiple applications 
for registration and that his registration would be inconsistent with 
the public interest. Id. at 1 (citing 21 U.S.C. 823(g)(1), 
824(a)(1)).\1\
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    \1\ The Agency need not adjudicate the criminal violations 
alleged in the OSC. See Ruan v. United States, 597 U.S. 450 (2022) 
(decided in the context of criminal proceedings).
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    On September 30, 2024, the Government submitted a RFAA to the 
Administrator requesting that the Agency issue a default final order 
denying Applicant's application. RFAA, at 1, 3-4. After carefully 
reviewing the entire record and conducting the analysis as set forth in 
detail below, the Agency grants the Government's request for final 
agency action and denies Applicant's application. As a preliminary 
matter, this Decision addresses whether or not Applicant is in default 
and finds that he is. Thereafter, this Decision makes specific factual 
findings on the alleged violations as set forth in the OSC. 
Specifically, this Decision considers whether Applicant submitted a 
materially false application and finds that he did. Additionally, this 
Decision considers whether Applicant's registration would be 
inconsistent with the public interest and finds that it would be. 
Lastly, this Decision determines that the appropriate sanction is 
denial of Applicant's application.

I. Default Determination

    Under 21 CFR 1301.43, a registrant or applicant 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 or applicant 
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).
    The OSC notified Applicant of his right to file a written request 
for a hearing and an answer, and that if he failed to file such a 
request and answer, he would be deemed to have waived his right to a 
hearing and be in default.\2\ RFAAX 1, at 14 (citing 21 CFR 1301.43). 
Here, Applicant did not request a hearing, file an answer, or respond 
to the OSC in any way. RFAA, at 1-3. Accordingly, Applicant is in 
default. 21 CFR 1301.43(c)(1).
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    \2\ Based on the Government's submissions in its RFAA dated 
September 30, 2024, the Agency finds that service of the OSC on 
Applicant was adequate. Specifically, the Declaration from a DEA 
Diversion Investigator (DI) indicates that on August 26, 2024, DI 
served the OSC on Applicant in-person and Applicant signed and 
initialed each page of the OSC. RFAAX 2, at 1; RFAAX 3. Accordingly, 
the Agency finds that due process notice requirements have been 
satisfied. Jones v. Flowers, 547 U.S. 220, 226 (2006).
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    ``A default, unless excused, shall be deemed to constitute a waiver 
of the [applicant's] right to a hearing and an admission of the factual 
allegations of the [OSC].'' 21 CFR 1301.43(e). Because Applicant is in 
default and has not moved to excuse the default, the Agency finds that 
Applicant has admitted to the factual allegations in the OSC. 21 CFR 
1301.43(c)(1), (e), (f)(1).
    Further, ``[i]n the event that [an applicant] . . . 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 Applicant's 
default pursuant to 21 CFR 1301.43(c)(1), (f)(1). RFAA, at 1-3; see 
also 21 CFR 1316.67.

II. Findings of Fact

    The Agency finds that, in light of Applicant's default, the factual 
allegations in the OSC are deemed admitted. 21 CFR 1301.43(e). 
Accordingly, Applicant is deemed to have admitted to each of the 
following facts.\3\
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    \3\ According to the Controlled Substances Act (CSA), 
``[f]indings of fact by the [DEA Administrator], if supported by 
substantial evidence, shall be conclusive.'' 21 U.S.C. 877. Here, 
where Applicant is found to be in default, all the factual 
allegations in the OSC are deemed to be admitted. These uncontested 
and deemed admitted facts constitute evidence that exceeds the 
``substantial evidence'' standard of 21 U.S.C. 877; it is unrebutted 
evidence.
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A. Material Falsification

January 2012 Application, Number W12001098M
    On January 6, 2012, Applicant submitted an application for DEA 
registration, which was assigned control number W12001098M. RFAAX 1, at 
9.
    The application's Liability Question 3 asked: ``Has the applicant 
ever surrendered (for cause) or had a state professional license or 
controlled substance registration revoked, suspended, denied, 
restricted, or placed on probation, or is any such action pending?'' 
Id.
    Applicant answered ``no'' to Liability Question 3. Id. In doing so, 
Applicant failed to disclose that: (a) in July 2007, Applicant's West 
Virginia registered nursing license, number 53904, was suspended; and 
(b) in October 2008, Applicant's Florida registered nursing license, 
number RN9221251, was suspended. Id. Applicant's January 2012 
application was approved and assigned DEA registration number 
MP2562432. Id.
October 2013 Application, Number W13085169M
    On October 12, 2013, Applicant submitted an application for DEA 
registration, which was assigned control number W13085169M. RFAAX 1, at 
9.
    The application's Liability Question 3 asked: ``Has the applicant 
ever surrendered (for cause) or had a state professional license or 
controlled substance registration revoked, suspended, denied, 
restricted, or placed on probation, or is any such action pending?'' 
Id.
    Applicant answered ``no'' to Liability Question 3. Id. In doing so, 
Applicant failed to disclose that: (a) in July 2007, Applicant's West 
Virginia registered nursing license, number 53904, was suspended; (b) 
in October 2008, Applicant's Florida registered nursing license, number 
RN9221251, was suspended; and (c) in July 2012, Applicant's application 
for a physician assistant license in North Dakota was denied. Id. at 9-
10. Applicant's October 2013 application was approved and assigned DEA 
registration number MP3221417. Id.

[[Page 48358]]

January 2016 Application, Number W16005281M
    On January 21, 2016, Applicant submitted an application for DEA 
registration, which was assigned control number W16005281M. RFAAX 1, at 
10.
    The application's Liability Question 2 asked: ``Has the applicant 
ever surrendered (for cause) or had a federal controlled substances 
registration revoked, suspended, restricted, or denied, or is any such 
action pending?'' Id.
    Applicant answered ``yes'' to Liability Question 2. Id. In response 
to the application's direction to provide the date and location of the 
incident that prompted the affirmative answer, Applicant stated: 
``January 30, 2015,'' and ``BEMIDJI, MINNESOTA.'' Id.
    In response to the application's direction to provide the nature of 
the incident, Applicant stated: ``ON 10/01/2014, I MISTAKENLY TOOK 
TABLETS OF SOMA.\4\ DURING MY PREVIOUS ABUSE OF SOMA, I HAD PLACED SOME 
SOMA TABLETS IN THE SAME CONTAINER AS MY ASPIRIN. ON 10/01/2014, I 
DEVELOPED A HEADACHE AND WENT INTO MY BATHROOM WITHOUT TURNING ON THE 
LIGHT (AS LIGHT INCREASES MY HEADACHES). I TOOK OUT THE BOTTLE OF 
ASPIRIN AND POURED THEM INTO MY HAND. I TOOK TWO TABLETS. THIS WAS AN 
UNINTENTIONAL INJECTION OF SOMA.'' Id.
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    \4\ Soma is a brand name for carisoprodol. See infra n.7.
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    In response to the application's direction to provide the result of 
the incident, Applicant stated: ``I WAS BEING MOUNTED BY MINNESOTA 
HEALTH PROFESSIONALS SERVICES PROGRAM. I DID A UA THE NEXT DAY. IT WAS 
POSITIVE FOR SOMA. AFTER AN INVESTIGATION BY MINNESOTA BOARD OF MEDICAL 
PRACTICE, THEY DETERMINED TREATMENT WAS NOT NECESSARY. FLORIDA 
PROFESSIONALS RESOURCE NETWORK BEGAN MONITORING ME (I ALSO HAVE A 
FLORIDA PA LICENSE). FLORIDA DID MANDATE TREATMENT. I WENT TO HAZELDEN 
BETTY FORD IN CENTER CITY, MN. I WAS THERE FOR 60 DAYS OF IN-PATIENT 
TREATMENT IN THE HEALTH CARE PROFESSIONALS SEC.'' Id.
    These descriptions most closely resemble circumstances relating to 
DEA registration number MP3221417, which Applicant surrendered for 
cause on January 30, 2015. Id.
    The application's Liability Question 3 asked: ``Has the applicant 
ever surrendered (for cause) or had a state professional license or 
controlled substance registration revoked, suspended, denied, 
restricted, or placed on probation, or is any such action pending?'' 
Id. at 11.
    Applicant answered ``yes'' to Liability Question 3. Id. In response 
to the application's direction to provide the date and location of the 
incident that prompted the affirmative answer, Applicant stated: 
``September 15, 2013,'' and ``MINNEAPOLIS, MN.'' Id.
    In response to the application's direction to provide the nature of 
the incident, Applicant stated: ``SOMETIME DURING THE FALL OF 2013, AND 
AFTER I COMPLETED 90-DAYS OF IN-PATIENT TREATMENT AT TALBOTT RECOVERY 
CAMPUS, I MEET WITH JACK HENDERSON & ANDY BIRD WITH THE MINNESOTA DEA 
AND SURRENDERED MY DEA LICENSE.'' Id.
    In response to the application's direction to provide the result of 
the incident, Applicant stated: ``MY DEA LICENSE WAS RE-ISSUED TO ME 
ABOUT A YEAR LATER.'' Id.
    These descriptions most closely resemble circumstances relating to 
DEA registration number MP2562432, which Applicant surrendered for 
cause on June 4, 2013, and not any state professional license or state 
controlled substance registration. Id.
    While Applicant made some disclosures in response to Liability 
Question 3, Applicant failed to disclose that: (a) in July 2007, 
Applicant's West Virginia registered nursing license, number 53904, was 
suspended; (b) in October 2008, Applicant's Florida registered nursing 
license, number RN9221251, was suspended; (c) in July 2012, Applicant's 
application for a physician assistant license in North Dakota was 
denied; (d) in January 2014, Applicant's Minnesota physician assistant 
license, number 10593, was suspended and the suspension was stayed; (e) 
in November 2014, Applicant's Minnesota physician assistant license, 
number 10593, was suspended; (f) in January 2015, Applicant's Minnesota 
physician assistant license, number 10593, was indefinitely suspended; 
and (g) in November 2015, Applicant's Minnesota physician assistant 
license, number 10593, was reinstated, suspended, and the suspension 
was stayed. Id. Applicant's January 2016 application was approved and 
assigned DEA registration number MP4140478. Id.
Renewal Application of DEA Registration, Number MP4140478
    On February 11, 2020, Applicant submitted an application to renew 
DEA registration number MP4140478. RFAAX 1, at 12. The application's 
Liability Question 3 asked: ``Has the applicant ever surrendered (for 
cause) or had a state professional license or controlled substance 
registration revoked, suspended, denied, restricted, or placed on 
probation, or is any such action pending?'' Id. Applicant answered 
``yes'' to Liability Question 3. Id.
    In response to the application's direction to provide the date and 
location of the incident that prompted the affirmative answer, 
Applicant stated: ``February 11, 2020,'' and ``NOTHING NEW TO REPORT.'' 
Id. In response to the application's direction to provide the nature of 
the incident, Applicant stated: ``NOTHING NEW TO REPORT SINCE LAST 
REGISTRATION.'' Id. In response to the application's direction to 
provide the result of the incident, Applicant stated: ``NOTHING NEW TO 
REPORT.'' Id.
    Applicant's follow-up responses to Liability Question 3 were false 
because Applicant again failed to disclose the incidents in West 
Virginia, Florida, North Dakota, and Minnesota that made his 
application, number W16005281M, false. Id. Applicant's February 2020 
renewal application for registration number MP4140478 was approved. Id.
May 2023 Application, Number W23054133M
    On May 2, 2023, Applicant submitted an application for DEA 
registration, which was assigned control number W23054133M. RFAAX 1, at 
12.
    The application's Liability Question 2 asked: ``Has the applicant 
ever surrendered (for cause) or had a federal controlled substances 
registration revoked, suspended, restricted, or denied, or is any such 
action pending?'' Id. Applicant answered ``yes'' to Liability Question 
2. Id. In response to the application's direction to provide the date 
and location of the incident that prompted the affirmative answer, 
Applicant stated: ``February 10, 2022,'' and ``MINNESOTA.'' Id.
    In response to the application's direction to provide the nature of 
the incident, Applicant stated: ``MY MN PHYSICIAN ASSISTANT LICENSE WAS 
SUSPENDED DUE TO MY DIVERSION OF PROPOFOL FOR SELF USE. I THEN HAD TO 
SURRENDER MY MN DEA REGISTRATION DUE TO MY MN PHYSICIAN ASSISTANT 
LICENSE BEING SUSPENDED.'' \5\ Id. In response to the application's 
direction to provide the result of the incident, Applicant

[[Page 48359]]

stated: ``I SURRENDERED MY MN DEA REGISTRATION.'' Id.
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    \5\ Propofol is a Schedule IV depressant. 21 CFR 1308.14(c)(27); 
RFAAX 1, at 8.
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    These descriptions most closely resemble circumstances relating to 
DEA registration number MP4140478, which Applicant surrendered for 
cause on November 16, 2021. Id.
    Though Applicant made some disclosures, he failed to disclose that 
he surrendered two additional DEA registrations. Specifically, he 
failed to disclose that on June 4, 2013, he surrendered for cause DEA 
registration number MP2562432, and on January 30, 2015, he surrendered 
for cause DEA registration number MP3221417. Id. at 13.
    Liability Question 3 asked: ``Has the applicant ever surrendered 
(for cause) or had a state professional license or controlled substance 
registration revoked, suspended, denied, restricted, or placed on 
probation, or is any such action pending?'' Id. Applicant answered 
``yes'' to Liability Question 3. Id. In response to the application's 
direction to provide the date and location, Applicant stated: ``May 1, 
2021,'' and ``MINNESOTA.'' Id.
    In response to the application's direction to provide the nature of 
the incident, Applicant stated: ``I DIVERTED PROPOFOL FOR SELF-USE IN 
AUGUST OF 2020 IN THE COUNTRY OF CURACAO WHILE ON A COVID-19 RAPID 
RESPONSE TEAM. I SELF-REPORTED THIS DIVERSION TO THE MINNESOTA HEALTH 
PROFESSIONALS SERVICES PROGRAM.'' Id.
    In response to the application's direction to provide the result of 
the incident, Applicant stated: ``MY MINNESOTA PHYSICIAN ASSISTANT 
LICENSE WAS SUSPENDED.'' Id. These descriptions most closely resemble 
circumstances relating to the indefinite suspension of Applicant's 
Minnesota physician assistant license, number 10593, on September 11, 
2021. Id.
    Again, Applicant failed to disclose the incidents in West Virginia, 
Florida, North Dakota, and Minnesota that made his application, number 
W16005281M, and his renewal application of registration number 
MP4140478, false. Id. at 13-14. Additionally, Applicant failed to 
disclose that on March 11, 2023, Applicant's Minnesota physician 
assistant license, number 10593, was suspended and the suspension was 
stayed. Id. at 14.

B. Public Interest

    Applicant is deemed to have admitted that in 2007, he was addicted 
to zolpidem \6\ and underwent treatment at a chemical addiction 
recovery program for sedative-hypnotic addiction. RFAAX 1, at 4.
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    \6\ Zolpidem is a Schedule IV depressant. 21 CFR 1308.14(c)(58); 
RFAAX 1, at 4.
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    In 2013, Applicant was abusing carisoprodol \7\ and was being 
monitored by the Florida Professionals Resource Network. Id. at 6. In 
April 2013, Applicant wrote a prescription for a volleyball teammate 
for 90 tablets of carisoprodol that authorized refills, and in 
exchange, Applicant's volleyball teammate promised to fill the 
prescription and provide Applicant with 30 carisoprodol tablets. Id. 
Applicant's volleyball teammate supplied Applicant with 30 of the 
carisoprodol tablets, which Applicant consumed. Id.
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    \7\ Carisoprodol is a Schedule IV depressant. 21 CFR 
1308.14(c)(7); RFAAX 1, at 6.
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    Approximately one month later, Applicant wrote another prescription 
for a different volleyball teammate for 90 tablets of carisoprodol that 
authorized refills, and in exchange, Applicant's second volleyball 
teammate promised to fill the prescription and provide Applicant with 
30 carisoprodol tablets. Id. Applicant's second volleyball teammate 
supplied Applicant with 30 of the carisoprodol tablets, which Applicant 
consumed. Id.
    In the summer of 2013, Applicant ordered carisoprodol tablets 
through the internet not for a legitimate medical purpose and not 
within the usual course of Applicant's professional practice. Id. The 
carisoprodol tablets were delivered to Applicant while he was a patient 
at a chemical addiction recovery program, which he attended from June 
2013 to August 2013. Id.
    On October 8, 2014, and October 20, 2014, Applicant tested positive 
for carisoprodol on two separate toxicology screens, when he did not 
have a prescription for carisoprodol. Id. at 7.
    In November 2015, Applicant consented to a stipulation and order 
issued by the Minnesota Board of Medical Practice after Applicant 
demonstrated completion of in-patient chemical dependency treatment, 
regular attendance at self-help program meetings, and random drug 
testing administered by the Florida Professionals Resource Network. Id. 
The stipulation and order required Applicant to demonstrate three years 
of uninterrupted recovery from substance abuse. Id.
    In November 2020, Applicant stole propofol from an operating room 
for his own personal use. Id. at 8.
    In September 2021, Applicant was subject to a stipulation and order 
issued by the Minnesota Board of Medical Practice that required 
Applicant to demonstrate six months of uninterrupted recovery from 
substance abuse, negative results on twelve random toxicology screens 
per quarter, regular attendance at self-help meetings in support of 
recovery, completion of a neuropsychological evaluation, and 
certification from medical professionals that Applicant was competent 
to safely resume practice. Id.

III. Discussion

A. Material Falsification

    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).\8\ 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 45229, 45238 (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 45230-39.
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    \8\ 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 33738, 
33744-45 (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

[[Page 48360]]

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 21719, 21720 (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 64940, 64945-46 (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 74800, 74802, 74808-09 (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 53942, 53956 
(2011) (omission of a probation which the application required to be 
identified); Michel P. Toret, M.D., 82 FR 60041, 60042 (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 52293, 52295 (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 8687, 8688 (1998) (``It is also undisputed that 
Respondent knew that his Ohio dental license had previously been 
suspended.''); Bobby Watts, M.D., 58 FR 46995, 46995 (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 45236-37 & 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 45234, 45238.
    The Government has the burden of proof in this proceeding, and the 
Agency must make its findings based on clear, unequivocal, and 
convincing record evidence. 21 CFR 1301.44(d); Kungys, 485 U.S. at 772; 
Stirlacci, 85 FR at 45230-39. Here, the Agency finds that the 
Government's record evidence presents a prima facie case that Applicant 
submitted five materially false applications. 21 U.S.C. 824(a)(1).
January 2012 Application, Number W12001098M
    The Agency finds the following facts based on clear, unequivocal, 
and convincing record evidence. On January 6, 2012, Applicant submitted 
an application for DEA registration, which was assigned control number 
W12001098M. RFAAX 1, at 9. Liability Question 3 asked whether Applicant 
had ever had any adverse action against a state professional license, 
to include revocation, suspension, probation, or denial. Id. Applicant 
falsely answered ``no.'' Id. Applicant's ``no'' answer to Liability 
Question 3 was false because he knew or should have known that 
information existed that the application required to be disclosed in 
response to Liability Question 3. Id. Specifically, Applicant knew or 
should have known that in July 2007 his West Virginia nursing license 
was suspended and that in October 2008 his Florida nursing license was 
suspended. Id.
    Additionally, Applicant's false answer was material. The CSA 
provides that suspension of a state license is one basis by which the 
Attorney General may suspend or revoke a DEA registration, and 
therefore, it is a relevant statutory factor for determining whether 
issuance or maintenance of a registration is inconsistent with the 
CSA.\9\ 21 U.S.C. 823(g)(1), 824(a)(3); Emed Medical Company LLC and 
Med Assist Pharmacy, 88 FR at 21720. Thus, whether an applicant has had 
a state license suspended is a relevant factor DEA must consider when 
reviewing an application, and failure to disclose such information has 
``a natural tendency to influence the [Agency's] decision.'' Kungys, 
485 U.S. at 771-72.
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    \9\ Because the bases for revocation listed in 21 U.S.C. 824 may 
also serve as bases to deny an application, see supra n.8, a finding 
of materiality may also be tied to 21 U.S.C. 824(a)(1)-(5).
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    Accordingly, the falsity in Applicant's January 2012 application 
directly affected the statutory analysis that DEA was required to make 
when it reviewed his application. 21 U.S.C. 823(g)(1), 824(a)(3). Thus, 
the falsity was material because it was ``predictably capable of 
affecting . . . [DEA's] official decision'' regarding whether Applicant 
met ``the requirements for'' registration. Kungys, 485 U.S. at 771.
    In sum, the Agency finds clear, unequivocal, and convincing record 
evidence that Applicant's January 6, 2012 application for DEA 
registration, control number W12001098M, was materially false. 21 
U.S.C. 824(a)(1); RFAAX 1, at 9.
October 2013 Application, Number W13085169M
    The Agency finds the following based on clear, unequivocal, and 
convincing record evidence. On October 12, 2013, Applicant submitted an 
application for DEA registration, which was assigned control number 
W13085169M. RFAAX 1, at 9. Liability Question 3 asked whether Applicant 
had ever had any adverse action against a state professional license, 
to include revocation, suspension, probation, or denial. Id. Applicant 
falsely answered ``no.'' Id. Applicant's ``no'' answer to Liability 
Question 3 was false because he knew or should have known that 
information existed that the application required to be disclosed in 
response to Liability Question 3. Id.
    Specifically, Applicant knew or should have known that in July 2007 
his West Virginia nursing license was suspended, in October 2008 his 
Florida nursing license was suspended, and in 2012 his application for 
a physician assistant license was denied in North Dakota. Id. at 9-10.
    Additionally, Applicant's false answer was material. The CSA 
provides that suspension or lack of a state license is one basis by 
which the Attorney General may suspend, revoke, or deny a DEA 
registration, and therefore, it is a relevant statutory factor for 
determining whether issuance or maintenance of a registration is 
inconsistent with the CSA. 21 U.S.C. 823(g)(1), 824(a)(3); Emed Medical 
Company LLC and Med Assist Pharmacy, 88 FR at 21720. Thus, whether an 
applicant has had a state license suspended or denied is a relevant 
factor DEA must consider when reviewing an application, and failure to 
disclose such information has ``a natural tendency to influence the 
[Agency's] decision.'' Kungys, 485 U.S. at 771-72.

[[Page 48361]]

    Accordingly, the falsity in Applicant's October 2013 application 
directly affected the statutory analysis that DEA was required to make 
when it reviewed his application. 21 U.S.C. 823(g)(1), 824(a)(3). Thus, 
the falsity was material because it was ``predictably capable of 
affecting . . . [DEA's] official decision'' regarding whether Applicant 
met ``the requirements for'' registration. Kungys, 485 U.S. at 771.
    In sum, the Agency finds clear, unequivocal, and convincing record 
evidence that Applicant's October 12, 2013 application for DEA 
registration, control number W13085169M, was materially false. 21 
U.S.C. 824(a)(1); RFAAX 1, at 9-10.
January 2016 Application, Number W16005281M
    The Agency finds the following based on clear, unequivocal, and 
convincing record evidence. On January 21, 2016, Applicant submitted an 
application for DEA registration, which was assigned control number 
W16005281M. RFAAX 1, at 10. Liability Question 2 asked, in part, 
whether Applicant has ever surrendered for cause a federal controlled 
substances registration. Id. Liability Question 3 asked whether 
Applicant had ever had any adverse action against a state professional 
license, to include revocation, suspension, probation, or denial. Id. 
at 11. Applicant answered ``yes'' to Liability Questions 2 and 3 and 
provided additional information to the follow-up prompts regarding 
date, location, nature, and result. Id. at 10-11.
    Despite truthfully answering ``yes,'' Applicant failed to disclose 
all the required information in response to Liability Question 3. 
Specifically, Applicant's follow-up responses failed to disclose that 
in July 2007 his West Virginia nursing license was suspended; in 
October 2008 his Florida nursing license was suspended; in 2012 his 
application for a physician assistant license was denied in North 
Dakota; and in January 2014, November 2014, January 2015, and November 
2015, his Minnesota physician assistant license was suspended. Id. 
Accordingly, Applicant's response to Liability Question 3 was false 
because he knew or should have known information existed that the 
application clearly required be disclosed in response to Liability 
Question 3.\10\ Id.
---------------------------------------------------------------------------

    \10\ In response to Liability Question 2, Applicant noted that 
the Minnesota Board of Medical Practice investigated him after a 
positive urinalysis but determined that ``treatment was not 
necessary.'' RFAAX 1, at 10. Applicant also noted that the Florida 
Professionals Resource Network ``began monitoring [him]'' and 
``mandate[d] treatment.'' Id. Although these responses indicate that 
he was investigated in Minnesota and monitored and required to 
undergo treatment in Florida, they fail to disclose, as Liability 
Question 3 required, that his nursing license was suspended in 
Florida in 2008 and his physician assistant license was suspended in 
Minnesota in 2014 and 2015. Id.
---------------------------------------------------------------------------

    Additionally, Applicant's false answer was material. The CSA 
provides that suspension or lack of a state license is one basis by 
which the Attorney General may suspend, revoke, or deny a DEA 
registration, and therefore, it is a relevant statutory factor for 
determining whether issuance or maintenance of a registration is 
inconsistent with the CSA. 21 U.S.C. 823(g)(1), 824(a)(3); Emed Medical 
Company LLC and Med Assist Pharmacy, 88 FR at 21720. Thus, whether an 
applicant has had a state license suspended or denied is a relevant 
factor DEA must consider when reviewing an application, and failure to 
disclose such information has ``a natural tendency to influence the 
[Agency's] decision.'' Kungys, 485 U.S. at 771-72.
    Accordingly, the falsity in Applicant's January 2016 application 
directly affected the statutory analysis that DEA was required to make 
when it reviewed his application. 21 U.S.C. 823(g)(1), 824(a)(3). Thus, 
the falsity was material because it was ``predictably capable of 
affecting . . . [DEA's] official decision'' regarding whether Applicant 
met ``the requirements for'' registration. Kungys, 485 U.S. at 771.
    In sum, the Agency finds clear, unequivocal, and convincing record 
evidence that Applicant's January 21, 2016 application for DEA 
registration, control number W16005281M, was materially false. 21 
U.S.C. 824(a)(1); RFAAX 1, at 10-11.
February 2020 Renewal Application, Registration Number MP4140478
    The Agency finds the following based on clear, unequivocal, and 
convincing record evidence. On February 11, 2020, Applicant submitted 
an application to renew DEA registration number MP4140478. RFAAX 1, at 
12. Liability Question 3 asked whether Applicant had ever had any 
adverse action against a state professional license, to include 
revocation, suspension, probation, or denial. Id. Applicant answered 
``yes.'' Id.
    Despite truthfully answering ``yes,'' Applicant failed to disclose 
all the required information in response to Liability Question 3. In 
response to the application's request for the date of the incident that 
prompted the ``yes'' answer, Applicant stated, ``February 11, 2020,'' 
the date he submitted the application. Id. In response to the 
application's request for the location, nature, and result of the 
incident, Applicant stated: ``NOTHING NEW TO REPORT.'' Id. Applicant's 
response to Liability Question 3 was false because he continued to fail 
to disclose the incidents that made his January 21, 2016 application, 
control number W16005281M, false. Id. Specifically, Applicant failed to 
disclose that in July 2007 his West Virginia nursing license was 
suspended; in October 2008 his Florida nursing license was suspended; 
in 2012 his application for a physician assistant license was denied in 
North Dakota; and in January 2014, November 2014, January 2015, and 
November 2015, his Minnesota physician assistant license was suspended. 
Id. at 11-12. Accordingly, Applicant's response to Liability Question 3 
was false because he knew or should have known information existed that 
the application required be disclosed in response to Liability Question 
3. Id.
    Additionally, Applicant's false answer was material. The CSA 
provides that suspension or lack of a state license is one basis by 
which the Attorney General may suspend, revoke, or deny a DEA 
registration, and therefore, it is a relevant statutory factor for 
determining whether issuance or maintenance of a registration is 
inconsistent with the CSA. 21 U.S.C. 823(g)(1), 824(a)(3); Emed Medical 
Company LLC and Med Assist Pharmacy, 88 FR at 21720. Thus, whether an 
applicant has had a state license suspended or denied is a relevant 
factor DEA must consider when reviewing an application, and failure to 
disclose such information has ``a natural tendency to influence the 
[Agency's] decision.'' Kungys, 485 U.S. at 771-72.
    Accordingly, the falsity directly affected the statutory analysis 
that DEA was required to make when it reviewed Applicant's application. 
21 U.S.C. 823(g)(1), 824(a)(3). Further, the falsity was material 
because it was ``predictably capable of affecting . . . [DEA's] 
official decision'' regarding whether Applicant met ``the requirements 
for'' registration. Kungys, 485 U.S. at 771.
    In sum, the Agency finds clear, unequivocal, and convincing record 
evidence that Applicant's February 11, 2020 application to renew DEA 
registration number MP4140478 was materially false. 21 U.S.C. 
824(a)(1); RFAAX 1, at 12.
May 2023 Application, Number W23054133M
    On May 2, 2023, Applicant submitted an application for DEA 
registration, which was assigned control number W23054133M. RFAAX 1, at 
12. Liability Question 2 asked, in part, whether

[[Page 48362]]

Applicant has ever surrendered for cause a federal controlled 
substances registration. Id. Applicant answered ``yes.'' Id. In 
response to the application's follow-up prompts, Applicant provided a 
date, location, and description of events that most closely resembled 
circumstances relating to the surrender of DEA registration number 
MP4140478 in November 2021 in Minnesota. Id. at 4, 12.
    Applicant, however, failed to disclose that he had previously 
surrendered two other DEA registrations in Minnesota. Specifically, he 
failed to disclose that on June 4, 2013, he surrendered for cause DEA 
registration number MP2562432, and on January 30, 2015, he surrendered 
for cause DEA registration number MP3221417. Id. at 3, 12-13. Although 
Applicant indicated that he ``SURRENDERED [HIS] MN DEA REGISTRATION,'' 
the information he provided on the application related to the surrender 
of only one Minnesota DEA registration, when, in fact, he previously 
held two additional DEA registrations that he also surrendered. Id. at 
12-13. Accordingly, Applicant's response to Liability Question 2 was 
false because he knew or should have known information existed that the 
application required be disclosed in response to Liability Question 2. 
Id.
    Liability Question 3 asked whether Applicant had ever had any 
adverse action against a state professional license, to include 
revocation, suspension, probation, or denial. Id. at 13. Applicant 
answered ``yes.'' Id. In response to the application's follow-up 
prompts, Applicant disclosed information that most closely resembled 
circumstances relating to the suspension of his Minnesota physician 
assistant license in September 2021. Id.
    Applicant, however, failed to disclose additional adverse actions 
against state licenses that he knew or should have known were required 
to be disclosed in response to Liability Question 3. Specifically, he 
failed to disclose that in 2007 his nursing license was suspended in 
West Virginia; in 2008 his nursing license was suspended in Florida; in 
2012 his application for a physician assistant license was denied in 
North Dakota; and in January 2014, November 2014, January 2015, 
November 2015, and March 2023, his physician assistant license was 
suspended in Minnesota. Id. at 13-14. Although Applicant disclosed one 
suspension of his physician assistant license in Minnesota in 2021, he 
failed to disclose suspensions of his Minnesota physician assistant 
license in 2014, 2015, and 2023. Id. Accordingly, Applicant's response 
to Liability Question 3 was false because he knew or should have known 
information existed that the application required be disclosed in 
response to Liability Question 3. Id.
    Additionally, Applicant's false answers to Liability Questions 2 
and 3 were material. The CSA provides that suspension or lack of a 
state license is one basis by which the Attorney General may suspend, 
revoke, or deny a DEA registration, and therefore, it is a relevant 
statutory factor for determining whether issuance or maintenance of a 
registration is inconsistent with the CSA. 21 U.S.C. 823(g)(1), 
824(a)(3); Emed Medical Company LLC and Med Assist Pharmacy, 88 FR at 
21720. Furthermore, a surrender for cause of a DEA registration 
implicates an applicant's or registrant's experience handling 
controlled substances and non-compliance with controlled substances 
laws, which are relevant considerations under Public Interest Factors B 
and D. 21 U.S.C. 823(g)(1). Thus, whether an applicant has had a state 
license suspended, an application for licensure denied, and/or has 
surrendered a previous DEA registration are all relevant factors DEA 
must consider when reviewing an application, and failure to disclose 
such information has ``a natural tendency to influence the [Agency's] 
decision.'' Kungys, 485 U.S. at 771-72.
    Accordingly, the falsities directly affected the statutory analysis 
that DEA was required to make when it reviewed Applicant's application. 
21 U.S.C. 823(g)(1), 824(a)(3). Further, the falsities were material 
because they were ``predictably capable of affecting . . . [DEA's] 
official decision'' regarding whether Applicant met ``the requirements 
for'' registration. Kungys, 485 U.S. at 771.
    In sum, the Agency finds clear, unequivocal, and convincing record 
evidence that Applicant's May 2, 2023 application for DEA registration, 
control number W23054133M, was materially false. 21 U.S.C. 824(a)(1); 
RFAAX 1, at 12-13.
    Further, although the instant OSC concerns whether Applicant's May 
2023 application should be granted, the Agency's decision to deny this 
application may also be based on the material falsification of 
Applicant's January 2012, October 2013, January 2016, and February 2020 
applications, because 21 U.S.C. 824(a)(1) provides that a registration 
may be revoked or denied based on the material falsification of ``any 
application filed pursuant to or required by'' the CSA. RFAAX 1, at 9-
12.

B. Public Interest

    Congress enacted the CSA ``to conquer drug abuse and control the 
legitimate and illegitimate traffic in controlled substances.'' 
Gonzales v. Raich, 545 U.S. 1, 12 (2005). A particular concern of 
Congress was ``the need to prevent the diversion of drugs from 
legitimate to illicit channels,'' and it ``devised a closed regulatory 
system making it unlawful to manufacture, distribute, dispense, or 
possess any controlled substance except in a manner authorized by the 
CSA.'' Id. at 12-13. To protect the American people and ensure 
compliance with the CSA, Congress empowered the Agency \11\ to deny, 
suspend, or revoke a registration if it would be inconsistent with the 
public interest. 21 U.S.C. 823(g)(1); 21 U.S.C. 824(a)(4); Gonzales v. 
Oregon, 546 U.S. 243, 251 (2006).
---------------------------------------------------------------------------

    \11\ The CSA grants this authority to the Attorney General, who 
has delegated it to the Administrator of DEA (the Agency). 28 CFR 
0.100.
---------------------------------------------------------------------------

    In determining whether Applicant's proposed registration is 
inconsistent with the public interest, the Agency analyzes five 
statutorily established ``public interest factors.'' Gonzales v. 
Oregon, 546 U.S. at 251; 21 U.S.C. 823(g)(1)(A)-(E). The five factors 
are:
    (A) The recommendation of the appropriate State licensing board or 
professional disciplinary authority.
    (B) The applicant's experience in dispensing, or conducting 
research with respect to controlled substances.
    (C) The applicant's conviction record under Federal or State laws 
relating to the manufacture, distribution, or dispensing of controlled 
substances.
    (D) Compliance with applicable State, Federal, or local laws 
relating to controlled substances.
    (E) Such other conduct which may threaten the public health and 
safety.
    21 U.S.C. 823(g)(1)(A)-(E).
    These five public interest factors are considered in the 
disjunctive. Gonzales v. Oregon, 546 U.S. at 292-93; Robert A. Leslie, 
M.D., 68 FR 15227, 15230 (2003). Each factor is weighed on a case-by-
case basis. David H. Gillis, M.D., 58 FR 37507, 37508 (1993). Any one 
factor, or combination of factors, may be decisive, Gillis, 58 FR at 
37508, and the Agency ``may give each factor the weight . . . deem[ed] 
appropriate in determining whether a registration should be revoked or 
an application for registration denied.'' Morall v. Drug Enf't Admin., 
412 F.3d 165, 185 n.2 (D.C. Cir. 2005) (Henderson, J., concurring) 
(quoting Robert A. Smith, M.D., 70 FR 33207, 33208 (2007)); see also 
Penick Corp. v. Drug Enf't Admin., 491 F.3d 483, 490 (D.C. Cir. 2007).

[[Page 48363]]

    While the Agency is required to consider each of the factors, it 
``need not make explicit findings as to each one.'' MacKay v. Drug 
Enf't Admin., 664 F.3d 808, 816 (10th Cir. 2011) (quoting Volkman v. U. 
S. Drug Enf't Admin., 567 F.3d 215, 222 (6th Cir. 2009)); Jones Total 
Health Care Pharmacy, LLC v. Drug Enf't Admin., 881 F.3d 823, 830 (11th 
Cir. 2018); Hoxie v. Drug Enf't Admin., 419 F.3d 477, 482 (6th Cir. 
2005). ``In short, . . . the Agency is not required to mechanically 
count up the factors and determine how many favor the Government and 
how many favor the registrant. Rather, it is an inquiry which focuses 
on protecting the public interest; what matters is the seriousness of 
the registrant's misconduct.'' Jayam Krishna-Iyer, M.D., 74 FR 459, 462 
(2009). Accordingly, as the Eleventh Circuit has recognized, Agency 
decisions have explained that findings under a single factor can 
support the denial of an application for registration. Jones Total 
Health Care Pharmacy, 881 F.3d at 830; Pharmacy Doctor Enterprises, 
Inc. v. Drug Enf't Admin., 789 Fed. Appx. 724, 729 (11th Cir. 2019).
    In this matter, the Government's evidence is confined to Factors B, 
D, and E. RFAA, at 4; RFAAX 1, at 4. Evidence is considered under 
Factors B and D when it reflects experience dispensing controlled 
substances and compliance or non-compliance with laws related to 
controlled substances. Kareem Hubbard, M.D., 87 FR 21156, 21162 (2022). 
Evidence is considered under Factor E when it constitutes ``[s]uch 
other conduct which may threaten the public health and safety.'' 21 
U.S.C. 823(g)(1)(E). To determine whether Applicant's registration is 
in the public interest, the Agency will evaluate the Government's 
allegations that Applicant has diverted controlled substances by 
issuing illegitimate prescriptions for the purpose of obtaining pills 
for personal use and that Applicant has a lengthy history of abusing 
controlled substances.\12\
---------------------------------------------------------------------------

    \12\ Due to the numerous and egregious public interest 
violations established in excess of substantial record evidence, the 
Agency need not address the remaining public interest violations 
alleged in the OSC.
---------------------------------------------------------------------------

    The Government has the burden of proof in this proceeding and the 
Agency must make its public interest findings based on substantial 
record evidence. 5 U.S.C. 556(d); 5 U.S.C. 706(2)(E); 21 U.S.C. 877; 21 
CFR 1301.44(d). If the Government meets its burden of establishing a 
prima facie case that granting Applicant's registration application is 
not in the public interest, then the burden shifts to Applicant to 
rebut the Government's case. Pharmacy Doctor Enterprises, 789 Fed. 
Appx. at 729 (citing Jones Total Health Care Pharmacy, 881 F.3d at 
830). Here, the Agency finds that the Government's record evidence 
presents a prima facie case that Applicant's registration would be 
inconsistent with the public interest. 21 U.S.C. 824(a)(4).
Public Interest Factors B and D: Diversion
    A lawful controlled substance order or prescription is one that is 
``issued for a legitimate medical purpose by an individual practitioner 
acting in the usual course of his professional practice.'' 21 CFR 
1306.04(a); RFAAX 1, at 2. Therefore, ``a physician who engages in the 
unauthorized practice of medicine is not a practitioner acting in the 
usual course of professional practice.'' United Prescription Servs., 
Inc., 72 FR 50397, 50407 (2007).
    Further, a registrant acts outside the usual course of professional 
practice and in a manner inconsistent with the public interest when he 
or she issues controlled substance prescriptions to individuals for the 
purpose of receiving some of the pills in return. See Michael E. Smith, 
D.V.M., 87 FR 4944, 4950-51 (2022) (finding registrant violated 21 CFR 
1306.04(a) and his registration was inconsistent with the public 
interest where he issued fraudulent prescriptions for controlled 
substances in order to obtain the drugs for personal use); Roger A. 
Pellmann, M.D., 76 FR 17704, 17709 (2011) (registrant violated federal 
law by obtaining controlled substances for ``office use,'' when he, in 
fact, was diverting the drugs to another individual and himself); 
Steven B. Brown, M.D., 75 FR 65660, 65662 (2010) (finding registrant 
violated 21 CFR 1306.04(a) by issuing controlled substance 
prescriptions in exchange for the individual to provide the registrant 
with half of the pills); Randall Relyea, D.O., 73 FR 40378, 40380 
(2008) (finding registrant's registration to be inconsistent with the 
public interest where he issued controlled substance prescriptions to 
individuals with no medical need and instructed them to give the drugs 
to him).
    Here, Applicant admits that around April and May 2013, he issued 
two prescriptions for carisoprodol in order to obtain some of the pills 
for personal use. RFAAX 1, at 6. Accordingly, the undisputed record 
evidence establishes, and the Agency finds, that Applicant has issued 
controlled substance prescriptions outside the usual course of 
professional practice and not for legitimate medical purposes in 
violation of 21 CFR 1306.04(a). See also Smith, 87 FR at 4950-51; 
Pellmann, 76 FR at 17709; Brown, 75 FR at 65662; Relyea, 73 FR at 
40380.
    Further, the Agency finds that this misconduct reflects poorly on 
Applicant's experience handling controlled substances and demonstrates 
non-compliance with Federal law governing controlled substances. 21 
U.S.C. 823(g)(1)(B), (D). Accordingly, the Agency finds substantial 
record evidence that Applicant's registration would be inconsistent 
with the public interest. 21 U.S.C. 824(a)(4).
Public Interest Factor E: Substance Abuse
    Past DEA decisions have consistently held that ``registrants who 
self-abuse controlled substances may endanger public health and 
safety,'' and that such misconduct may be considered under Factor E. 
See Brewster Drug, Inc., 85 FR 19020, 19026 (2020) (collecting cases).
    Here, Applicant's admissions establish that Applicant has a long 
history of abusing controlled substances. Specifically, in 2007 
Applicant was addicted to zolpidem and underwent treatment at a 
chemical addiction recovery program. RFAAX 1, at 4. In addition, in 
2013 Applicant was abusing carisoprodol and was in a chemical addiction 
recovery program. Id. at 6. Further, despite being in treatment for 
addiction to carisoprodol, Applicant ordered carisoprodol tablets 
through the internet not for a legitimate medical purpose and not 
within the usual course of his professional practice. Id. On two 
occasions in 2014, Applicant tested positive for carisoprodol when he 
did not have a prescription for carisoprodol. Id. at 7. In November 
2020, Applicant stole propofol from an operating room for personal use. 
Id. at 8. In 2015 and 2021, Applicant was subject to orders issued by 
the Minnesota Board of Medical Practice that, among other things, 
required Applicant to undergo treatment for chemical dependency, attend 
self-help program meetings, undergo random drug testing, and 
demonstrate sobriety. Id. at 7-8.
    In sum, the Agency finds substantial record evidence that Applicant 
has abused a variety of controlled substances over a period of many 
years and continued to do so even after he had been monitored and 
required to undergo treatment for substance abuse. Id. at 4, 6-8. The 
Agency finds that this lengthy history of substance abuse constitutes 
``other conduct which may threaten the public health and safety.'' 21 
U.S.C. 823(g)(1)(E); Brewster Drug, Inc., 85 FR at 19026. Accordingly, 
the Agency finds substantial record

[[Page 48364]]

evidence that Applicant's registration would be inconsistent with the 
public interest. 21 U.S.C. 824(a)(4).

IV. Sanction

    The Agency has found by clear, unequivocal, and convincing record 
evidence that Applicant submitted five materially false applications 
for DEA registration and substantial record evidence that his 
registration would be inconsistent with the public interest due to 
having committed acts of diversion and demonstrating a lengthy history 
of substance abuse. 21 U.S.C. 823(g)(1)(B), (D), (E); 21 U.S.C. 
824(a)(1), (4). When the Government establishes a prima facie case for 
sanction, as it did here, the Agency then determines the appropriate 
sanction, which may include denial of an application for registration. 
21 U.S.C. 823(g)(1); see also Pharmacy Doctors Enterprises, 789 Fed. 
Appx. at 734 (the Agency is entitled to choose a sanction); Jeffrey 
Stein, M.D., 84 FR 46968, 46972-73 (2019); Scott Hansen, A.R.N.P., 90 
FR 27338, 27341 (2025).
    At this stage, the burden is on Applicant to show why he can be 
entrusted with a registration. Morall, 412 F.3d at 174; Jones Total 
Health Care Pharmacy, 881 F.3d at 830; Garrett Howard Smith, M.D., 83 
FR 18882, 18904 (2018). The issue of trust is necessarily a fact-
dependent determination based on the circumstances presented by the 
individual. Stein, 84 FR at 46972; see also Jones Total Health Care 
Pharmacy, 881 F.3d at 833.
    As past performance is the best predictor of future performance, 
the Agency requires that an applicant who has committed acts 
inconsistent with the public interest accept responsibility for those 
acts and demonstrate that they will not engage in future misconduct. 
See 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). Moreover, the 
Agency requires an applicant's unequivocal acceptance of 
responsibility. Janet S. Pettyjohn, D.O., 89 FR 82639, 82641 (2024); 
Mohammed Asgar, M.D., 83 FR 29569, 29573 (2018); see also Jones Total 
Health Care Pharmacy, 881 F.3d at 830-31. The Agency also considers the 
need to deter similar acts by the applicant and by the community of 
registrants. Stein, 84 FR at 46972-73.
    Here, Applicant failed to request a hearing and answer the 
allegations contained in the OSC, and did not otherwise avail himself 
of the opportunity to prove to the Agency that he can be entrusted with 
a registration. See supra Section I. Thus, there is no record evidence 
that Applicant takes responsibility, let alone unequivocal 
responsibility, for the misconduct proven by record evidence. 
Accordingly, he has not convinced the Agency that he can be entrusted 
with the responsibilities of a registration.
    Further, the interests of specific and general deterrence weigh in 
favor of denial. Applicant's misconduct in this matter concerns the 
submission of registration applications that contained material 
falsities, improper prescribing for the purpose of obtaining controlled 
substances for personal abuse, and a lengthy history of abusing 
controlled substances. Thus, the proven misconduct goes to the heart of 
the CSA's ``strict requirements regarding registration'' and its 
``closed regulatory system'' specifically designed ``to conquer drug 
abuse and to control the legitimate and illegitimate traffic in 
controlled substances.'' Gonzales v. Raich, 545 U.S. at 12-14. If the 
Agency were to issue a registration to Applicant under these 
circumstances, it would send a dangerous message that compliance with 
the law is not essential to obtaining a registration.
    In sum, Applicant has not offered any credible evidence on the 
record that rebuts the Government's case for denial of his application, 
and Applicant has not demonstrated that he can be entrusted with the 
responsibility of a DEA registration. Accordingly, the Agency will 
order the denial of Applicant's application for registration.

Order

    Pursuant to 28 CFR 0.100(b) and the authority vested in me by 21 
U.S.C. 823(g)(1), I hereby deny the application for a DEA Certificate 
of Registration, Control No. W23054133M, submitted by David S. Pecora, 
P.A., as well as any other pending application of David S. Pecora, 
P.A., for registration in Minnesota. This Order is effective November 
17, 2025.

Signing Authority

    This document of the Drug Enforcement Administration was signed on 
October 1, 2025, by Administrator Terrance Cole. 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. 2025-19579 Filed 10-16-25; 8:45 am]
BILLING CODE 4410-09-P


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Indexed from Federal Register on October 17, 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.