06-004005PL Department Of Health, Board Of Medicine vs. David Danzer, M.D. Status: Closed Recommended Order on Monday, April 2, 2007.

Summary: Respondent failed to report out-of-state discipline.

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF HEALTH, )

BOARD OF MEDICINE, )

)

Petitioner, )

) Case No. 06 - 4005 PL

vs. )

)

DAVID B. DANZER, M.D., )

)

Respondent. )

)

RECOMMENDED ORDER

Notice was provided and on J anuary 23, 200 7 , a formal

hearing was held in this case . Authority for conducting the

hearing is set forth in S ections 120.569 and 1 20.57(1), Florida

Statutes ( 2006 ) . The hearing location was the offices of the

Division of A dministrative Hearings , 1230 Apalachee Parkway,

Tallahassee , Florida . The hearing was conducted by Cha rles C.

Adams, Administrative Law Judge .

APPEARANCES

For Petitioner: Al lison M . Dudley, Esquire

John Terrel , Esquire

Department of Health

4052 Bald Cypress Way, Bin C - 65

Tallahassee, Florida 32399 - 3265

For Respondent: John D. Buchanan , Esquire

Henry, Buchanan, Hudson,

Suber & Carter, P.A.

Post Office Drawer 14079

Tallahassee , Florida 32 317

STATEMENT OF THE ISSUE

Should discipline be impose d against Respondent 's medical

license for alleged violations of Section 458.331(1)(b) and

(kk), Florida Statutes ?

PRELIMINARY STATEMENT

On December 1 5 , 200 3 , by a n Administrative Complaint i n

Department of Health, Petitioner vs. David Danzer, M.D.,

Respondent , Department of Health (DOH) Case No. 2002 - 05082,

Respondent was accused of violating the aforementioned statutes.

The case concerns alleged action taken by the State of Rhode

Island a n d Providence Plantations, Department of Health and the

State of New York , Department of Health against Respondent 's

medical licenses issued in those jurisdictions and Respondent 's

failure to report to the Florida Board of Medicine (the Board) ,

i n writing , t hat the out - of - state action against the foreign

licenses to practice medicine had been taken.

DOH provided Respondent with an election of rights form ,

which created options in responding to the Administrative

Complaint . Respondent chose the option whic h was one in which

he indicated that he dispu ted the allegations of fact found in

the Administrative Complaint , thereby requesting a hearing to

resolve the disputed issues of material fact as contemplated by

Sections 120.569 and 120.57, Florida Statutes . According to the

form, Respondent specified the paragraphs within the

Administrative Complaint that were disputed. The election of

rights was executed on January 12, 2004 , through his attorney.

On October 13, 2006 , DOH forwarded the case to Robert S.

Co hen, Director of the Division of Administrative Hearings

(DOAH), for conduct of a formal hearing pursuant to Respondent 's

request for a formal hearing. The case was established as DOAH

Case No. 06 - 4005PL, and assigned to the present administrative

law jud ge . A written notice of hearing date was provided and

the hearing proceeded as noticed.

On October 31, 2006 , Respondent filed an answer to the

Administrative Complaint .

On November 6, 2006 , Petitioner filed a notice of serving

Petitioner 's First Reque st for Admissions directed to

Respondent . On December 13, 2006 , Respondent filed a Response

to Petitioner 's First Request for Admissions.

On January 4, 2007, Petitioner filed a Motion to Relinquish

Jurisdiction. On January 5, 2007, Petitioner filed ano ther

Motion to R elinquish J urisdiction . On January 10, 2007,

Respondent filed a Response to Petitioner 's Motion to Relinquish

Jurisdiction . On January 12, 2007, Petitioner filed a

supplement to its M otion to R elinquish J urisdiction . On

January 12, 2007, an order was entered denying the Motion to

Relinquish Jurisdiction .

On January 12, 2007, Respondent filed a Motion to Compel

Petitioner to Produce a complete file on Dr. Danzer for the

hearing scheduled to be held on January 23, 2007. On

January 17, 20 07, Petitioner filed a response to the M otion to

C ompel. On January 18, 2007, an order was entered denying the

M otion to C ompel.

On January 22, 2007, Petitioner filed a Motion for Official

Recognition of Section 458.331(1)(b) and (kk), Florida Statutes

(2000) and (200 1 ) ; Florida Administrative Code Rule 64B8 - 8.001,

in effect from December 28, 1999 , until January 3, 2001, and

Florida Administrative Code Rule 64B8 - 8.001, in effect form

January 21, 2001 , through July 9, 2001 . No opposition to the

motion wa s expressed. The M otion for O fficial R ecognition was

granted at the hearing.

Petitioner presented Janie Shingles as its witness.

Petitioner's Exhibit s numbered 1 through 4 were admitted.

Respondent testified in his own behalf . Respondent 's Exhibit s

n umbered 1 and 2 w ere admitted. Respondent 's Exhibit numbered 3

was denied admission. Respondent's Exhibit s numbered 4 through

6 were admitted. Respondent's Exhibit s numbered 7 through 10

were denied admission. Respondent's Exhibit numbered 11 was

admit ted. All exhibits , to include those denied admission , are

forwarded as part of the hearing record.

Respondent , with Petitioner 's concurrence , filed a Motion

to Extend the Time for filing proposed findings of fact and

conclusions of law from the deadli ne established when the

hearing concluded. F la . A dmin . C ode R. 28 - 106.215. The partie s

were orally informed that the request for extension had been

granted to be memorialized in the Recommended Order . With this

extension , the due date for entering the R ecommended Order ha s

also been e x tended. F la . A dmin . Code R. 28 - 106.216.

The hearing transcript was filed on February 5, 2007.

P etitioner and Respondent filed proposed recommended order s

which have been considered in preparing the Recommended Order .

FIN DINGS OF FACT

License Status

1. David Danzer, M.D. , Respondent is a licensed physician

in Florida , License No. ME 13568.

Rhode Island

2. Respondent , who is licensed to practice medicine in

Rhode Island , had been investigated by a committee within the

St ate of Rhode Island and Providence Plantation s, Department of

Health, Board of Medical Licensure and Discipline (the Rhode

Island Board). The c omplaint concern ed Respondent 's conduct in

providing care to Patient Z.P. , an infant.

3. On June 11, 1993, the Rhode Island Board wrote to

Respondent to advise him that it had voted a finding of no

unprofessional conduct in association with the investigation

related to Patient Z.P. Subsequently, the estate of Patient

Z.P. and another p erson sued Respondent a n d Kent County Memorial

Hospital, in the Superior Court for Kent County of Rhode Island ,

Civil Action No. 94 - 275, in which a settlement was reached and a

general release executed on October 9, 1997.

4 . At the time Respondent was investigated by the Rhode

Island Board in 1993 and during the pendency of the civil suit

leading to the a settlement in 1997, Respondent was represented

by a Rhode Island attorney, David W. Carroll. Mr. Carroll had

been hired to represent Respondent by an insurance company that

co vered Respondent 's medical practice.

5 . While the litigation was pending in the civil case

involving Patient Z.P. 's estate, Mr. Carroll received

correspondence from the Rhode Island Board that an investigative

board committe e had recommended the imposit ion of a sanction for

unprofessional conduct that was ratified by the Rhode Island

Board. This pertained to the Patient Z.P. The corresponde nce

was dated April 18, 1995. The Rhode Island Board offered to

resolve the regulatory case through a C onsent O rd er.

Respondent 's counsel opposed the reopening of the regulatory

case in the S uperior C ourt in Rhode Island , the trial level

court. Ultimately, the Supreme Court of the State of Rhode

Island decided that the Rhode Island B o a r d had the authority to

procee d. In Case No. C94 - 151 before t h e Rhode Island Board , the

parties resolved their dispute through a C onsent O rder.

Petitioner's Exhibit numbered 1. The findings of fact in that

order stated:

1. The Respondent , a physician, board

certified in emergency medicine prescribed

the drug Novahistine to a one month old male

infant. The next day the infant was

presented to the same hospital room in

cardiac arrest. The medical examiner who

performed the autopsy found that the one

month old infant died as a resu lt of acute

opiate intoxication.

2. The Board finds that the medication

prescribed by the respondent was contra

indicated for an infant of this age. The

Board finds that the Respondent did not meet

acceptable community care professional

standards in such a practice in violation of

RIGL 5 - 37 - 5.1(19).

6 . In its operative terms the C onsent O rder stated:

(7) The Respondent accepts the Board's

finding of unprofessional conduct with the

Sanction of a Reprimand. Additionally, the

Respondent agrees t o attend te n hours in

continuing education in emergency medicine

in the area of pediatrics within one year of

ratification of this order.

(8) The Respondent agrees to pay an

administrative fee of $1,000 (one thousand

dollars) within 6 months of ratific ation of

this order.

7. The C onsent O rder was entered on August 9, 2000.

Respondent did not report to the Board in Florida , in writing ,

the entry of the C onsent O rder by the Rhode Island Board within

30 days of the action or at any other time. Petit ioner's

Exhibit numbered 4.

8. Mr. Carroll knew that Respondent was licensed to

practice in other states than Rhode Island . In his deposition

presented as Respondent's Exhibit numbered 11 , admitted into

evidence, Mr. Carroll did not recall in which stat es Respondent

held a medical license in addition to the Rhode Island medical

license. Back in time when the C onsent O rder was entered by the

Rhode Island Board , it was not Mr. Carroll's practice to advise

his clients, to include Respondent , or to research the law of

other jurisdictions to determine what reporting requirements

might be in advising foreign jurisdictions of the Rhode Island

action. Mr. Carroll has no recollection of any discussions with

Respondent about reporting , other than that he typicall y would

tell his clients if you get inquiries, taken to mean from

another jurisdiction , " T he response to the inquiry may be

dependent upon what the question is." Respondent 's case here is

the first instance where reporting to other states has been

brought to Mr. Carroll 's attention as something that would have

to be more actively considered.

New York

9. Respondent was licensed to practice as a physician in

the s tate of New York. The State of New York , Department of

Health, State Board for Professional Medical Conduct (the New

York Board ) took action against Respondent for alleged

professional misconduct. The case was styled I n the M atter of

David B . Danzer, M.D., CO - 01 - 02 - 0729 - A. Petitioner 's Exhibit

n umbered 2 . Respondent was repres ented in that action by an

attorney assigned by the insurance company that covered

Respondent 's medical practice . The case in New York was

resolved by a C onsent A greement and O rder BPMC No. 01 - 323. The

C onsent A greement and O rder refers to the fact :

Th at on or about February 20, 1975,

Respondent was licensed to practice as a

physician in New York , having been issued

license no. 122935 , by the New York State

Education Department .

The C onsent A greement and O rder referred to the attached

S tatement of C h arges annexed to th e document as an exhibit. The

C onsent A greement and O rder states in pertinent part , in

relation to the agreement by the parties, in particular the

Respondent :

I have never practiced medicine in New York

and I do not intend to return t o practice

medicine in New York state. I, therefore,

do not contest Factual Allegations A and

B(1) and the two (2) specifications, in full

satisfaction of the charges against me. I

hereby agree to the following penalties:

Censure and Reprimand.

* * *

10. The factual allegations within the S tatement of

C harges that Respondent had agreed to in the C onsent A greement

and O rder stated in pertinent part:

A. On or a bout October 20, 2000, the stat e

of Rhode Island and Providence Plantations,

Department of Health, Board of Medical

Licensure and Discipline (hereinafter ' Rhode

Island Board'), by a Consent Order

(Hereinafter ' Rhode Island Order'),

Reprimanded Respondent , imposed a $1,000.00

administrative fee, and required ten (10)

ho urs of CME, based upon Respondent

prescribing the drug Novahistine to a one

month old male infant who presented the next

day in cardiac arrest and died as a result

of acute opiate intoxication.

B. The conduct resulting in the Rhode

Island Board discip linary action against

Respondent would constitute misconduct under

the laws of New York state, pursuant to the

following sections of New York state Law:

1. New York Education Law § 6530(4) ; (gross

negligence); and/or

2. New York Education Law § 6 530(5) ; (gross

incompetence.

11. The C onsent A greement and Order was finalized on

December 18, 2001. Respondent did not report to the Board in

Florida , in writing , within 30 days of the C onsent O rder and

Agr eement entered by the New York Board , that the action had

been taken or at any other time. Respondent's Exhibit numbered

4. The record here does not reveal that someone acting in

Respondent 's behalf reported the outcome in the New York action

to the Boar d in Florida .

12. On November 3, 2005, the New York Board entered a

M odification O rder in BMPC No. 01 - 323. Petitioner's Exhibit

numbered 3. In pertinent part the M odification O rder states:

In response an application to modify the

consent order:

* * *

ORDERED that the attached Application, and

it terms, are adopted SO ORDERED, . . .

13. In the application to modify the C onsent O rder and

Agreement Respondent requested the following:

I apply, hereby, to the State Board f or

Professional Medical Conduct for a

Modification Order (hereinafter

'Modification Order'), modifying the

Original Order, as follows: to delete the

language in the Original Order that states:

That, except during periods of actual

suspension, Responden t shall maintain active

registration of Respondent 's license with

the New York State Education Department

Division of Professional Licensing Services,

and pay all registration fees. This

condition shall be in effect beginning

thirty days after the effecti ve date of the

Consent Order and will continue while the

licensee possesses his/her license; and

substituting therefore:

I shall never activate my registration to

practice medicine in New York state or seek

to reapply for a license to practice

medicine in New York state.

The Modification Order to be issued will not

constitute a new disciplinary action against

me, but will substitute the proposed

language for the above described language in

the Original Order.

14. As was stated the M odification O rder did not

constitute a new disciplinary case against Respondent . It was

by way of the New York Board accepting Respondent 's position

that he would never activate the registration in New York or

seek to reapply to practice medicine in that state. The

M odification O rder by the New York Board is not addressed in the

Administrative Complaint in terms of any necessity for

Respondent to make the B oard in Florida aware that the New York

Board had entered the M odification O rder.

License History

15. It was not shown that Respondent has any disciplinary

history in Florida prior to this case. Respondent has not

practiced in Florida in the past but wishes to maintain the

option to practice in the state.

CONCLUSIONS OF LAW

1 6 . The Division of Admini strative Hearings has

jurisdiction over the parties and the subject matter of this

proceeding in accordance with Sections 120.569 , 120.57(1) and

456.073 , Florida Statutes (200 6).

1 7 . The Board licensed Respondent to practice medicine in

Florida . As a licensee certain acts on his part could

constitute grounds for disciplinary action. § 458.331, Fla.

Stat. (2000) and § 458.331, Fla. Stat. (2001) .

18. Through the Administrative Complaint , the Board

intends to take disciplinary action against Respon dent based

upon the alleged actions by the Rhode Island Board i n entering

its C onsent Order and the New York Board by its C onsent

A greement and O rder and the alleged failure by Respondent to

advise the Board in Florida concerning those actions. There are

four counts to the Administrative Complaint .

1 9 . Count One to the Administrative Complaint in relation

to the C onsent O rder entered by the Rhode Island Board accuses

Respondent of violating Section 458.331(1)(b), Florida Statutes

( 200 0 ) , which states:

Grounds for disciplinary action; action by

the board and department:

(1) The following acts shall constitute

grounds for which the disciplinary actions

specified in subsection (2) may be taken:

* * *

(b) Having a licen se or the authority to

practice medicine revoked, suspended, or

otherwise acted against, including the

denial of licensure, by the licensing

authority of any jurisdiction, including its

agencies or subdivisions. The licensing

authority's acceptance of a p hysi cian's

relinquishment of a license, stipulation,

consent order, or other settlement, offered

in response to or in anticipation of the

filing of administrative charges against the

physician's license, shall be construed as

action against the physician's license.

20. Count Two to the Administrative Complaint in relation

to the action taken by the Rhode Island Board accuses Respondent

of violating Section 458.331(1)(kk), Florida Statutes (2000) ,

which states:

Grounds for disciplinary action; action by

the board and department:

(1) The following acts shall constitute

grounds for which the disciplinary actions

specified in subsection (2) may be taken:

* * *

(kk) Failing to report to the boa rd, in

writing, within 30 days i f action as defined

in paragraph (b) has been taken against

one's license to practice medicine in

another state, territory, or country.

21. Count Three to the Administrative Complaint in

relation to the Consen t Agreement and Order entered by the New

Y ork Board accuses Respondent of violating Section

458.331(1)(b), Florida Statutes (2001) , which states:

Grounds for disciplinary action; action by

the board and department:

(1) The following acts constitute grounds

for denial of a license or disciplina ry

action, as specified in s. 456.072(2):

* * *

(b) Having a license or the authority to

practice medicine revoked, suspended, or

otherwise acted against, including the

denial of licensure, by the licensing

authority of any juri sdiction, including its

agencies or subdivisions. The licensing

authority's acceptance of a physician's

relinquishment of a license, stipulation,

consent order, or other settlement, offered

in response to or in anticipation of the

filing of administrative charges against the

physician's license, shall be construed as

action against the physician's license.

22. Count Four to the Administrative Complaint in relation

to the action taken by the New York Board accuses Respondent of

violating Section 4 58.331(1)(kk), Florida Statutes (2001), which

states:

(1) The following acts constitute grounds

for denial of a license or disciplinary

action, as specified in s. 456.072(2):

(kk) Failing to report to the board in

writing, within 30 da ys if action as defined

in paragraph (b) has been taken against

one's license to practice medicine in

another state, territory, or county.

23. Petitioner bears the burden of proof in this

disciplinary case. That proof must be sufficient to sustain th e

allegations in the Administ rative Complaint by clear and

convincing evidence. See Department of Banking and Finance ,

Division of Securities and Investor Protection v. Osborne Stern

and Co. , 670 So. 2d 932 (Fla. 1996); and Ferris v. Turlington ,

510 So. 2 d 292 (Fla. 1987) . The term clear and convincing

evidence is explained in the case In re: Davey , 645 So. 2d 398

(Fla. 1994) , quoting , with approval from Slomowitz v. Walker ,

429 So. 2d 797 (Fla. 4th DCA 1983).

24. Concerning Count One , the Rhode Island B oard accepted

a C onsent O rder between the parties , action against Respondent 's

license to practice in that state. Therefore Respondent

violated Section 458.331(1)(b), Florida Statutes (2000) , and is

subject to one or more of the penalties set forth in Sec tion

458.331(2), Florida Statutes (2000).

25. Concerning Count Two , Respondent failed to report to

the Board in Florida , in writing , within 30 days of the action

taken by the Rhode Island Board , the C onsent O rder. Therefore

Respondent violated Section 458.331(1)(kk), Florida Statutes

(2000) , and is subject to one or more penalties found at Section

458.331(2), Florida Statutes (2000).

26. Concerning Count T hree , the New York Board accepted a

C onsent A greement and O rder offered in response to the

admin istrative charge s against R espondent 's New York l icense.

Therefore Respondent violated Section 458.331(1)(b ), Florida

Statutes (2001 ) , and is subject to one or more penalties found

at Section 45 6 . 072 (2), Florida Statutes (200 1 ).

27. Concerning Count Fou r Respondent failed to report to

the Board in Florida , in writing , within 30 days of the action

taken by the New York Board through the C onsent A greement and

O rder. Therefore Respondent violated Section 458.331(1)(kk),

Florida Statutes (2001) , and is subj ect to one or more penalties

found at Section 456.072(2), Florida Statutes (2001).

28. Section 458.3 3 1(2), Florida Statutes (2000), states :

When the board finds any person guilty of

any of the grounds set forth in subsection

(1), including conduct tha t would constitute

a substantial violation of subsection (1)

which occurred prior to licensure, it may

enter an order imposing one or more of the

following penalties:

(a) Refusal to certify, or certification

with restrictions, to the department an

app lication for licensure, certification, or

registration.

(b) Revocat ion or suspension of a license.

(c) Restriction of practice.

(d) Imposition of an administrative fine

not to exceed $10,000 for each count or

separate offense.

(e) Issuance of a reprimand.

(f) Placement of the physician on probation

for a period of time and subject to such

conditions as the board may specify,

including, but not limited to, requiring the

physician to submit to treatment, to attend

continuing education courses , to submit to

reexamination, or to work under the

supervision of another physician.

(g) Issuance of a letter of concern.

(h) Corrective action.

(i) Refund of fees billed to and collected

from the patient.

(j) Imposition of an administrative fi ne in

accordance with s. 381.0261 for violations

regarding patient rights.

In determining what action is a ppropriate,

the board must first consider what sanctions

are necessary to protect the public or to

compensate the patient. Only after those

sanctions have been imposed may the

disciplining authority consider and include

in the order requirements designed to

rehabilitate the physician. All costs

associated with compliance with orders

issued under this subsection are the

obligation of the physician.

29. Section 456.072(2), Florida Statutes (2001), states:

When the board, or the department when there

is n o board, finds any person guilty of the

grounds set forth in subsection (1) or of

any grounds set forth in the applicable

practice act, including conduct constituting

a substantial violation of subsection (1) or

a violation of the applicable practice act

w hich occurred prior to obtaining a license,

it may enter an order imposing one or more

of the following penalties:

(a) Refusal to certify, or to certify with

restrictions, an application for a license.

(b) Suspension or permanent revocation of a

lice nse.

(c) Restriction of practice or license,

including, but not limited to, restricting

the licensee from practicing in certain

settings, restricting the licensee to work

only under designated conditions or in

certain settings, restricting the licensee

from performing or providing designated

clinical and administrative services,

restricting the licensee from practicing

more than a designated number of hours, or

any other restriction found to be necessary

for the protection of the public health,

safety, a nd welfare.

(d) Imposition of an administrative fine

not to exceed $10,000 for each count or

separate offense. If the violation is for

fraud or making a false or fraudulent

representation, the board, or the department

if there is no board, must impose a fine of

$10,000 per count or offense.

(e) Issuance of a reprimand or letter of

concern.

(f) Placement of the licensee on probation

for a period of time and subject to such

conditions as the board, or the department

when there is no board, may speci fy. Those

conditions may include, but are not limited

to, requiring the licensee to undergo

treatment, attend continuing education

courses, submit to be reexamined, work under

the supervision of another licensee, or

satisfy any terms which are reasonably

ta ilored to the violations found.

(g) Corrective action.

(h) Imposition of an administrative fine in

accordance with s. 381.0261 for violations

regarding patient rights.

(i) Refund of fees billed and collected

from the patient or a third party on behalf

of the patient.

(j) Requirement that the practitione r

undergo remedial education.

In determining what action is appropriate,

the board, or department when there is no

board, must first consider what sanctions

are necessary to protect the public or to

compensate the patient. Only after those

sanctions have been imposed may the

disciplining authority c onsider and include

in the order requirements designed to

rehabilitate the practitioner. All costs

associated with compliance with orders

issued under this subsection are the

obligation of the practitioner.

30 . For the violations in Counts One and Two, Florida

Administrative Code Rule 64B8 - 8.001 in e ffect from December 28,

1999, until January 30, 2001, offers guidance on punishment to

include a discussion of aggravating and mitigating

circumstances. No indication was given concerning the manner in

whic h the Board in Florida would respon d if the substantive

violation that took place in Rhode Island would have occurred in

Florida to assist when deciding the penalty for violating

Section 458.331(1)(b), Florida Statutes (2000). Concerning the

aggravation a nd mitigation , the patient in Rhode Island died.

T here were no restraints or legal constraints on Respondent at

the time of the action in Rhode Island or at present in Florida .

There are two counts involving a single offense originating in

Rhode Island . T here is no indication of a previous commission

of this type of offense . T he disciplinary history in Rhode

Island is known. T he Respondent gained no pecuniary benefit or

self - gain under the circumstances in Rhode Island . The

violations did not involve a provision of controlled substance s.

Without the ability to compare the Florida experience for a

similar sustentative violation occurring in Rhode Island , the

license in Rhode Island being unencumbered at present, a

$1,000.00 administr ative fine for Coun t One and a $2,000.00

administrative fine for Count Two are within the range of

suggested penalties within the guidelines and are deemed

appropriate.

31. Concerning Counts Three and Four, action by the New

York Board , it is derivative of the experience in Rhode Island .

For that reason a written reprimand would remind Respondent of

his need to report the New York Board C onsent A greement and

O rder and coincides with the New York response to the Rhode

Island action .

RECOMMENDAT ION

Upon consideration , it is

RECOMMENDED:

That a final order be entered finding Respondent in

violation of Section 458.331(1)(b) and (kk), Florida Statutes

(2000), and Section 458.331(1)(b) and (kk) , Florida Statutes

(2001) , related to Counts One thro ugh Four, imposing an

administrative fine of $3,000.00 and issuing a written

reprimand.

DONE AND ENTERED this 2nd day of April , 200 7 , in

Tallahassee, Leon County, Florida.

S

___________________________________

CHARLES C. ADAMS

Administrative Law Jud ge

Division of Administrative Hearings

The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399 - 3060

(850) 488 - 9675 SUNCOM 278 - 9675

Fax Filing (850) 921 - 6847

www.doah.state.fl.us

Filed with the Clerk of the

Division of Administrative Heari ngs

this 2nd day of April , 200 7 .

COPIES FURNISHED :

Allison M. Dudley, Esquire

John Terrel , Esquire

Department of Health

4052 Bald Cypress Way, Bin C - 65

Tallahassee, Florida 32399 - 3265

John D. Buchanan , Esquire

Henry, Buchanan, Hudson,

Suber & Carter, P.A.

Post Office Drawer 14079

Tallahassee , Florida 32317

Larry McPherson, Executive Director

Board of Medicine

Department of Health

4052 Bald Cypress Way

Tallahassee, Florida 32399 - 1701

Josefina M. Tamayo, General Counsel

De partment of Health

4052 Bald Cypress Way , Bin A02

Tallahassee, Florida 32399 - 1701

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written excep tions within

15 days from the date of this Recommended Order. Any exceptions

to this Recommended Order should be filed with the agency that

will issue the final order in this case.