Uvienome Linda Sakor, N.P.; Decision and Order, 50173-50180 [2021-19194]

Agencies

• Drug Enforcement Administration
• Department of Justice

[Federal Register Volume 86, Number 170 (Tuesday, September 7, 2021)]
[Notices]
[Pages 50173-50180]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-19194]


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 DEPARTMENT OF JUSTICE

Drug Enforcement Administration


Uvienome Linda Sakor, N.P.; Decision and Order

I. Introduction

    On June 19, 2019, the Assistant Administrator, Diversion Control 
Division, Drug Enforcement Administration (hereinafter, DEA or 
Government), issued an Order to Show Cause (hereinafter, OSC) to 
Uvienome Sakor, N.P., also known as Uvienome Linda Sakor, N.P., 
(hereinafter, Respondent) of Douglasville, Georgia. OSC, at 1. The OSC 
proposed the revocation of Respondent's Certificate of Registration No. 
MS1972101, the denial of any pending applications for renewal or 
modification of that registration, and the denial of any applications 
for additional DEA registrations for two reasons. Id. First, it alleged 
that Respondent ``materially falsified multiple renewal applications . 
. . filed with the DEA.'' Id. (citing 21 U.S.C. 824(a)(1)). Second, it 
alleged that Respondent ``pled guilty to a felony relating to 
controlled substances.'' OSC, at 1 (citing 21 U.S.C. 824(a)(2)).
    Specifically, the OSC alleged that Respondent entered a guilty plea 
in Georgia Superior Court to one count of Forgery in the First Degree 
``for attempting to fill a forged controlled substance prescription.'' 
OSC, at 2. This OSC allegation acknowledged that, under Georgia's First 
Offender Act, Respondent was discharged from probation, was exonerated 
of any criminal purpose, and is not considered to have a criminal 
conviction. Id.
    Second, the OSC alleged that Respondent entered into a Consent 
Order with the Georgia Board of Nursing (hereinafter, GBN) for her 
failure to report her Forgery guilty plea as required by Georgia 
statute. Id. It also alleged that the Consent Order placed Respondent 
on probation for two years. Id.
    Third, the OSC alleged that Respondent submitted three materially 
false registration renewal applications after her guilty plea because 
she did not respond affirmatively to the first Liability question. Id. 
at 2-3. Similarly, the OSC alleged that Respondent submitted two 
materially false registration renewal applications after the beginning 
of the Consent Order's probationary period because she did not respond 
affirmatively to the third Liability question. Id. at 3.
    Fourth, the OSC alleged that Respondent's guilty plea to the state 
Forgery charge implicates 21 U.S.C. 824(a)(2). Id.
    The OSC notified Respondent of the right to request a hearing on 
the allegations or to submit a written statement, while waiving the 
right to a hearing, the procedures for electing each option, and the 
consequences for failing to elect either option. Id. at 4 (citing 21 
CFR 1301.43). The OSC also notified Respondent of the opportunity to 
submit a corrective action plan. OSC, at 4-5 (citing 21 U.S.C. 
824(c)(2)(C)).
    The Government forwarded its Request for Final Agency Action 
(hereinafter, RFAA), along with the evidentiary record, to this office 
on September 5, 2019. Attached to the RFAA is the Declaration of a DEA 
Diversion Investigator (hereinafter, DI) that is signed and sworn to 
under penalty of perjury. RFAA Exhibit (hereinafter, RFAAX) 6 
(Declaration of Diversion Investigator, dated September 5, 2019 
(hereinafter, DI Declaration)). The DI Declaration states that the DI 
``personally served'' the OSC on Respondent at her registered location 
on June 24, 2019. Id. at 3. I credit the DI's sworn statement.
    Respondent waived her right to a hearing and filed a written 
statement. RFAAX 3 (Respondent's Written Statement, dated July 17, 2019 
(hereinafter, Written Statement)), at 1. Her Written Statement 
explicitly references the OSC. Id.
    Based on all of the evidence in the record, I find that the 
Government's service of the OSC was legally sufficient. In addition, 
based on all of the evidence in the record, I find that Respondent 
timely filed her Written Statement. 21 CFR 1301.43.
    I issue this Decision and Order based on the Government's 
submission, which includes the Written Statement, and is the entire 
record before me. 21 CFR 1301.43(e).

II. Findings of Fact

A. Respondent's DEA Controlled Substance Registration

    Respondent is the holder of DEA Certificate of Registration No. 
MS1972101 at the registered address of 6559 Church St., Douglasville, 
GA 30134-1885. RFAAX 1 (Certification of Registration History, dated 
September 4, 2019), at 1. Pursuant to this registration, Respondent is 
authorized to dispense controlled substances in schedules III through V 
as a MLP-nurse practitioner.\1\ Id. Respondent's registration expired 
on February 28, 2021, and is in an ``active pending status.'' Id.
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    \1\ MLP means Mid-Level Practitioner. 21 CFR 1300.01(b).
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B. The Investigation of Respondent

    According to the DI assigned to this matter, ``a large number of 
prescriptions that had been issued by . . . [Respondent] had been 
filled'' at a pharmacy the DI was investigating, and Respondent is the 
sister of the pharmacy's owner. RFAAX 6, at 1. The DI Declaration 
states that Respondent ``previously had been convicted of a felony 
involving forgery and that her nursing license had been placed on 
probation.'' Id. According to the DI Declaration, the DI's 
investigation included obtaining certified copies of records of the 
Superior Court of Douglas County and of the GBN. Id. at 2; see also 
infra section II.C.

C. The Government's Case

    The Government's case includes five exhibits, one of which is the 
Written Statement.
    The first exhibit is the Certification of Registration History. 
RFAAX 1. According to that Certification, Respondent submitted to the 
Agency registration renewal applications on December 31, 2011, February 
25, 2015, and January 5, 2018. Id. at 1. On each of the three 
submissions, the Certification of Registration History states, 
Respondent answered ``No'' to whether she ``has . . . ever been 
convicted of a crime in connection with controlled substance(s) under 
state or federal law, . . . or any such action pending.'' Id. at 1-2, 
4, 7, 10. Further, on each of the three submissions, according to the 
Certification of Registration History, Respondent answered ``No'' to 
whether she ``has

[[Page 50174]]

. . . 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 2, 4, 7, 10.
    The next exhibit is the OSC, RFAAX 2, and the third exhibit is the 
Written Statement, RFAAX 3.
    The next exhibit consists of ten documents certified by the ``Clerk 
Superior/State Court'' as true and correct copies from case ``10CR00980 
State of Georgia vs. Linda U. Sakor.'' \2\ RFAAX 4, at 1; see also 
RFAAX 6, at 2. The first document is one page consisting of the 
``Petition for Discharge of Defendant (First Offender Act)'' and the 
signed ``Order of Discharge,'' dated March 20, 2012. RFAAX 4, at 2. In 
this document, a probation officer states that Respondent is ``eligible 
for discharge as shown by having fulfilled the term of . . . probation 
and upon review of . . . [her] criminal record.'' Id. Below the 
probation officer's statement, the Court's signed Order of Discharge 
states that (1) Respondent is ``discharged without Court adjudication 
of guilt,'' (2) the ``discharge shall completely exonerate . . . 
[Respondent] of any criminal purpose,'' (3) the ``discharge shall not 
affect any of . . . [Respondent's] civil rights or liberties,'' (4) 
Respondent ``shall not be considered to have a criminal conviction,'' 
and (5) the ``discharge may not be used to disqualify a person in any 
application for employment or appointment to office in either the 
public or private sector by reason of criminal conviction . . . unless 
otherwise provided by law.'' Id.
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    \2\ Although the certification for RFAAX 4 references ``Linda U. 
Sakor,'' five of the documents in RFAAX 4 refer to ``Uvienome Linda 
Sakor,'' three of the documents refer to ``Linda Sakor,'' one 
document refers to ``Linda U. Sakor,'' and one document does not 
refer to anyone by name. RFAAX 4, at 2 (Linda U. Sakor); id. at 3-26 
(Uvienome Linda Sakor); id. at 27-30 (Linda Sakor); id. at 31 (no 
name). I find substantial record evidence that all of the documents 
in RFAAX 4 pertain to Respondent.
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    The second document, consisting of fifteen pages, is the 
``Transcript of Proceedings'' of the criminal hearing on November 18, 
2010. Id. at 3-17. The Transcript states that Respondent was present 
with her attorney ``to enter a negotiated guilty plea.'' Id. at 4. 
According to the Assistant District Attorney (hereinafter, ADA), 
Respondent changed employers in July of 2008. Early in 2009, the ADA 
stated, Respondent presented a prescription for hydrocodone, 
purportedly issued by her previous employer, to be filled at a 
pharmacy. Id. at 9. The ADA indicated that Respondent had forged the 
prescription in the name of her previous employer. Id. at 10. He also 
stated that ``[t]here's no evidence that there were any other forged 
prescriptions presented'' by Respondent. Id.; see infra section II.E. 
Respondent's Public Defender added that Respondent had ``retained the 
[prescription] pad after she had left their employ and basically she 
wrote prescriptions out for herself which basically she would have to 
have gone back to the doctor to get that authorized prior to the time 
this was done and that's not the way it was done.'' RFAAX 4, at 13 
[emphasis added]; see infra section II.E.
    When the Court invited her to speak, Respondent stated that ``nurse 
practitioners actually do have the authority and . . . [she has] the 
authority, . . . [has] the license to write prescriptions for people in 
the State of Georgia as in many other states, and that is part of . . . 
[her] job.'' RFAAX 4, at 14-15. She did not mention the controlled 
substance schedule parameters, schedules III through V, of her federal 
authority to issue controlled substance prescriptions. She finished by 
stating that she ``did the wrong thing in writing it for . . . 
[her]self.'' Id. at 15. When the Court asked her why she forged the 
prescription, she stated that she ``was having severe pain and could 
not make it to . . . [her] doctor's office.'' Id. When the Court asked 
her, she denied having ``any sort of drug abuse problem.'' Id. The 
Transcript ends with the Court imposing the recommended sentence and 
treating Respondent as a first offender. Id. at 15-16.
    The third document is the one-page Plea Sheet filed on November 18, 
2010. Id. at 18. The Plea Sheet shows that Respondent pled guilty to 
one count, that she was to undergo substance abuse counseling, that she 
was fined $1,000, and that she received a sentence of five years' 
probation with the possibility of four years being suspended ``after 
completion of 1st year of probation successfully.'' Id.
    The fourth document is the one-page Waiver of Rights, dated 
November 18, 2010. Id. at 19. This document, signed by Respondent and 
her attorney, lists the rights that Respondent waived by pleading 
guilty. Id. Over the Court's signature, the document states that 
``inquiry has been made of the . . . [Respondent] concerning the rights 
listed,'' that the Court is ``satisfied there is an adequate factual 
basis to support the guilty plea,'' and that the Court is satisfied 
that Respondent ``is acting knowingly, freely and voluntarily and no 
promise, threat or force has been used to induce the . . . [Respondent] 
to enter this plea.'' Id.
    The document comprising the next three pages is the ``First 
Offender Treatment Order,'' the ``General Conditions of Probation,'' 
and the ``Special Conditions of Probation Imposed Pursuant to Code 42-
8-34.1,'' dated November 18, 2010. Id. at 20-22. This document shows 
that Respondent ``negotiated'' a guilty plea to one count and was 
sentenced to five years, which may be served on probation, and the 
payment of a $1,000 fine. Id. at 20-21.
    The sixth set of documents concerns the ``Felony Accusation'' about 
Respondent. Id. at 23-26. The documents indicate that Respondent pled 
guilty to one count of ``Forgery in the First Degree (O.C.G.A. 16-9-
1)'' on November 18, 2010. Id. at 23, 24, and 26. Her attorney and the 
ADA signed the fully completed document along with Respondent. Id. at 
26.
    The next two documents, ``Entry of Appearance; and Notice of Intent 
to Engage in Reciprocal Discovery'' and ``Rule 5.2(2) Certificate of 
Service of Discovery,'' dated April 24, 2010, show that Respondent was 
represented by counsel at the proceedings. Id. at 27-28. These 
documents also show two ``unindicted'' case numbers. Id.
    The ninth document is the two-page ``Affidavit for Arrest'' 
concerning Respondent, signed by a Douglas County Magistrate Judge on 
March 30, 2010. Id. at 29-30. The first page shows a warrant in the 
matter of ``The State of GA vs. [Respondent]'' charging four counts of 
Forgery, a Felony in the First Degree, with bail set at $16,000. Id. at 
29. The second page of the ``Affidavit for Arrest'' shows a warrant in 
the matter of ``The State of GA vs. [Respondent]'' charging one count, 
Theft by Taking, a misdemeanor, with bail set at $1,000. Id. at 30.
    The tenth and final document is entitled ``Arrest Warrant, County 
of Douglas, State of Georgia, Exhibit: A page 1 of 1'' to the Forgery 
in the First Degree ``Affidavit for Arrest,'' filed on April 2010.\3\ 
Id. at 31. The ``Arrest Warrant'' describes four counts of Forgery in 
the First Degree. The first count concerns the ``knowing,'' ``with 
intent to defraud'' making of a ``certain writing in such a manner that 
the writing as made purports to have been made by authority of one . . 
. who did not give such authority at another time and did deliver said 
writing being a prescription for Hydrocodon [sic] and Phenergan.'' Id. 
The other three counts specifically concern the delivery to a pharmacy 
of forged prescriptions for Vicodin and Phenergan on September 8, 2009, 
Tussionex Pennkinetic on

[[Page 50175]]

November 6, 2009, and Vicodin, Ibuprofin, and Phenergan on November 11, 
2009. Id.
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    \3\ The day in April is not legible. RFAAX 4, at 31.
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    The first page of the next exhibit is the Certification of the GBN, 
dated July 23, 2019, concerning its Consent Order with Respondent and 
the statement that ``Respondent has met the terms and conditions 
outlined in this order.'' RFAAX 5, at 1. The second page is the GBN 
letter to Respondent, dated July 20, 2015, advising Respondent that her 
``license is unencumbered and free of the conditions imposed by'' the 
Consent Order. Id. at 2.
    The remaining ten pages of RFAAX 5 is the June 25, 2013 Consent 
Order between Respondent and the GBN. Id. at 3-11. The first page of 
the Consent Order states that Respondent pled guilty, ``[o]n or about 
November 18, 2010,'' to the ``felony criminal offense of Forgery, First 
Degree in the Superior Court of Douglas County.'' Id. at 3. It also 
states that ``Respondent failed to report her felony conviction to the 
Board within ten (10) days of such conviction as required'' by Georgia 
statute. Id. Page three of the Consent Order states that, ``[u]pon the 
effective date of this Consent Order, the Respondent's license to 
practice as a registered professional nurse and authorization to 
practice as an advanced practice nurse in the State of Georgia shall be 
placed on probation for a period of two (2) years, or until lifted by 
the Board.'' Id. at 5. The Consent Order specifies that ``this Consent 
Order, once approved and docketed, shall constitute a public record, 
evidencing disciplinary action by the Board.'' Id. at 10. The Consent 
order was approved on June 20, 2013, and docketed on June 25, 2013. Id. 
at 10, 3.
    The last exhibit of the RFAA is the DI Declaration. RFAAX 6. In 
addition to certifying some of the Government's other exhibits and 
providing the origins of the investigation leading to the OSC, as 
already discussed, the DI Declaration affirms that Respondent pled 
guilty to one felony count ``for attempting to fill a forged controlled 
substance prescription'' and ``agreed [with the GBN], among other 
things, to be placed on probation for a period of two (2) years.'' Id. 
at 2.

D. Respondent's Case

    As already discussed, Respondent submitted a timely Written 
Statement. Supra section I. In her Written Statement, Respondent stated 
that she was responding to the ``material falsification of renewal 
applications for . . . [her] DEA license'' by ``writ[ing] a statement 
of explanation.'' \4\ RFAAX 3, at 1. Respondent began the explanation 
by stating that ``[i]n the year 2008, . . . [she] made a very grave 
mistake which . . . [she] will forever regret.'' Id. She elaborated, 
stating that she ``wrote a prescription for . . . [her]self in 2008 on 
a prescription pad which belonged to . . . [her] collaborating 
physician.'' Id. The prescription, according to her Written Statement, 
``was for Vicodin which is also known as Hydrocodone 5/500 mg.'' Id. 
She ``did this,'' she stated, ``because . . . [she] was in severe 
menstrual pain and could not make it to see . . . [her] personal 
physician to prescribe this medication for . . . [her].'' Id. 
Respondent wrote that she ``presented this prescription to a local 
pharmacy who notified the physician . . . [she] worked with, and then 
proceeded to notify the local authorities.'' Id. She stated that 
``[s]ince then . . . [she has] undergone a lot of emotional stress 
regarding the risk . . . [she] placed . . . [her] career in.'' Id.
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    \4\ Respondent explicitly ``request[ed] a waiver of a hearing.'' 
RFAAX 3, at 1.
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    According to her Written Statement, she pleaded nolo contendere and 
``was sentenced under the first offender act [sic] and upon completion 
of . . . [her] one-year probation was noted not to have a felony 
conviction.'' Id. ``It was based on this understanding,'' Respondent 
wrote, ``that . . . [she] responded to the questions in . . . [her] 
subsequent DEA renewal applications.'' Id. Specifically, she admitted 
that ``[i]n December of 2011 on . . . [her] DEA renewal application, . 
. . [she] responded `No' to liability question 1 with the understanding 
that . . . [she] was not guilty of a felony substance control 
conviction.'' Id.
    Regarding her nursing license, Respondent stated that she 
``answered `Yes' on the renewal of . . . [her GBN] license to the 
questions regarding a pleading Nolo Contedere [sic] and was then placed 
on a two-year probationary period in 2013 which after careful 
monitoring was lifted in 2013.'' Id. According to her Written 
Statement, she ``underwent psychological evaluation and testing 
requested by the . . . [GBN] which concluded that . . . [she] did not 
have substance abuse problems and was able to practice safely as a 
nurse.'' Id. Regarding the registration renewal applications she 
submitted, she admitted that, in 2015 and 2018, she ``answered ``no'' 
to liability question 2 [sic] with the understanding because at that 
time . . . [her] nursing license was no longer under probation.'' \5\ 
Id.
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    \5\ Respondent may have meant to refer to Liability question 
``3,'' not ``2.''
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    Respondent addressed her three false answers to the first Liability 
question on the registration renewal applications she submitted in 
December, 2011, February, 2015, and January, 2018, and her two false 
answers to the third Liability question on the registration renewal 
applications she submitted in 2015 and in 2018. Id. She stated that she 
``did not intentionally answer these questions to misrepresent or give 
false information for . . . [her] DEA application.'' Id. Respondent 
wrote that she ``also renewed . . . [her] Georgia nursing license and 
when faced with similar questioning ha[s] answered yes to . . . [her] 
Nolo Contendere plea with an explanation of the situation.'' Id. She 
did not attach documentary evidence to support this assertion.
    Respondent's Written Statement states that she ``prescribe[s] 
medications to patients in . . . [her] role as a nurse practitioner'' 
and that she has practiced as a nurse, and then a nurse practitioner, 
``for the past 25 years.'' Id. Respondent stated that she ``cannot 
emphasize how sorry . . . [she] is that . . . [she has] placed 
[her]self in such a position.'' Id. at 2. She stated that she is a 
mother of two and a wife, that she has ``worked hard throughout . . . 
[her] life to have a successful career which . . . [she] placed in 
jeopardy,'' and that she is ``an upstanding member of . . . [her] 
community and church and [has] never abused any medications.'' Id. The 
Written Statement characterizes the ``circumstances'' as her 
``unwittingly submit[ting] the wrong responses on . . . [her] renewal 
applications,'' and, ``instead of a complete revocation'' of her 
registration, ``appeal[s]'' for ``a period of either probation or 
suspension with monitoring and the ability to reapply or renew'' her 
registration. Id.
    I find substantial record evidence that Respondent admitted, in her 
Written Statement, to writing a prescription for herself in 2008 on a 
prescription pad belonging to her collaborating physician. Id. at 1. 
This wrongdoing by Respondent is not set out in the Government's case. 
While the Government's case presents evidence of one negotiated guilty 
plea by Respondent arising from events in 2009, I find substantial 
record evidence that the Written Statement references ``a very grave 
mistake'' of forgery by Respondent in 2008. Compare RFAAX 4, 3-16 and 
id. at 29-31 with RFAAX 3, at 1; see also RFAAX 5, at 1 (referring to 
Respondent's ``plea of guilty to the felony criminal offense of 
Forgery, First Degree in the Superior Court of Douglas County . . . 
pertain[ing] to her forging prescriptions in 2009 for pain medication 
for her own use''). I further

[[Page 50176]]

find, based on substantial record evidence, that the ``Affidavit for 
Arrest'' and the ``Arrest Warrant'' state that Respondent presented 
four forged prescriptions for filling in 2009, the year after 
Respondent's 2008 ``very grave mistake'' forgery admission described in 
her Written Statement. RFAAX 4, at 29-31. I find substantial record 
evidence that one of the instances described in the Arrest Warrant 
corresponds to the facts underlying Respondent's negotiated guilty plea 
according to the Transcript of that plea. Id. at 9.
    There is substantial fact congruity between the evidence submitted 
by the Government and Respondent's Written Statement. The glaring 
exceptions to this substantial fact congruity are the number of 
controlled substance prescription forgeries the evidence indicates and 
the number of times Respondent pled to forging a controlled substance 
prescription.
    Regarding the number of controlled substance prescription forgeries 
the evidence indicates, there are significant differences between the 
Written Statement's description of the forgery Respondent states took 
place in 2008, and the forgery underlying her 2009 guilty plea 
documented in the Government's evidence along with the alleged 
forgeries described in the Arrest Warrant. These significant 
differences lead me to conclude that they describe two different 
forgeries. For example, in its description of the four purported self-
prescribed controlled substance prescriptions, the Arrest Warrant 
differentiates between brand names and generic names for controlled 
substances. See, e.g., RFAAX 4, at 31 (Arrest Warrant description of 
four purported self-prescribed controlled substance prescriptions for 
``hydrocodone,'' ``Vicodin,'' ``Tussionex Pennkinetic,'' and 
``Vicodin''). The Written Statement states that the forged prescription 
she wrote for herself in 2008 ``was for Vicodin which is also known as 
Hydrocodone 5/500 mg.'' RFAAX 3, at 1. The Transcript of Respondent's 
guilty plea, on the other hand, describes the forged prescription of 
2009 to have been for ``hydrocodone.'' RFAAX 4, at 7. While the Written 
Statement explains that ``Vicodin is also known as Hydrocodone,'' this 
is in direct contrast to the record evidence in the Arrest Warrant that 
provides the precise name of the controlled substance entered on the 
purportedly forged prescriptions. Accordingly, in this context, I find 
that ``Vicodin,'' not ``hydrocodone,'' is a noteworthy departure and 
points to two different forgeries.
    By way of further example, according to the Written Statement, 
Respondent wrote the Vicodin prescription for herself in 2008 ``on a 
prescription pad which belonged to . . . [her] collaborating 
physician'' and she ``presented this prescription to a local pharmacy 
who notified the physician . . . [she] worked with and then proceeded 
to notify the local authorities.'' RFAAX 3, at 1. According to the 
Transcript of her 2009 guilty plea, by contrast, the prosecutor stated 
that Respondent left the employ of a medical practice in 2008 to work 
for another medical practice. RFAAX 4, at 9. Several months after that 
job change, he stated, Respondent presented a forged hydrocodone 
prescription written on a pad that belonged to the previous employer. 
Id. at 9-10. The pharmacy contacted Respondent's new employer and then 
the previous employer who ``informed them that he did not write or 
authorize this prescription.'' Id. at 10. The previous medical practice 
notified law enforcement. Id. Neither Respondent nor her Public 
Defender corrected any part of these prosecutor statements. Instead, 
the Public Defender added that Respondent had retained the prescription 
pad from the former employer and forged the prescription while at the 
subsequent employment. Id. at 11. I find that the differences between 
the Written Statement and the guilty plea Transcript on these critical 
points are too significant to result from faulty memory. I further find 
that the absence of any correction of those differences by Respondent 
or her Public Defender during the guilty plea proceeding means that the 
2008 forgery described in the Written Statement and the forgery to 
which Respondent pled guilty in 2009 are not the same. Consequently, I 
find that the Written Statement describes a different forgery than the 
forgery to which Respondent pled guilty and the forgeries alleged in 
the Arrest Warrant. RFAAX 4, at 31. I consider the fact that the 2009 
guilty plea for forging a controlled substance in the Government's 
evidence was not an isolated incident in determining the appropriate 
sanction.\6\ Infra section IV.
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    \6\ Although I find this fact relevant to my determination of a 
sanction, there is more than enough record evidence without it to 
support revocation as a sanction based on the Government's prima 
facie case.
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    Regarding the number of forgery pleas, the Written Statement 
describes a 2008 nolo contendere plea for forging a controlled 
substance prescription. RFAAX 3, at 1. The conviction described in the 
Government's evidence is a 2009 guilty plea for forging a controlled 
substance prescription on February 5, 2009. RFAAX 4, at 3-16; see also 
RFAAX 5, at 1 (referring to Respondent's ``plea of guilty to the felony 
criminal offense of Forgery, First Degree in the Superior Court of 
Douglas County . . . pertain[ing] to her forging prescriptions in 2009 
for pain medication for her own use''). I need not sort out whether 
there were two pleas or one plea because the OSC alleges one felony 
conviction and because I am carrying out the provisions of 21 U.S.C. 
824 regarding that felony conviction alleged in the OSC. 28 CFR 
0.100(b). Whether Respondent pled nolo contendere to a violation in 
2008 is not an issue presented by the OSC, is not before me for 
adjudication, and, therefore, I shall not resolve it.

E. Allegation That Respondent Has Been Convicted of a Felony Related to 
a Controlled Substance (21 U.S.C. 824(a)(2))

    I find that there is substantial record evidence that Respondent, 
after leaving employment at a medical practice, retained a prescription 
pad of a doctor in that medical practice. Id. at 13 (statement of 
Respondent's attorney). I find that there is substantial record 
evidence that Respondent used the prescription pad after leaving that 
employment to ``wr[i]te prescriptions out for herself'' without 
authorization of the doctor to whom the prescription pad belonged. Id. 
(statement of Respondent's attorney). I find that there is substantial 
record evidence that Respondent ``would have to have gone back to the 
doctor to get that [prescription] authorized prior to the time this was 
done and that's not the way it was done.'' Id. (statement of 
Respondent's attorney).
    I find that there is substantial record evidence that Respondent 
presented for filling a controlled substance (hydrocodone) prescription 
on February 5, 2009, that this prescription purported to be issued by a 
doctor at her former employment, and that this prescription was one of 
the unauthorized prescriptions Respondent wrote for herself on the 
prescription pad of a doctor at her former employment. Id. at 9.
    I find that there is substantial record evidence that the 
pharmacist investigated this prescription. Id. at 10. I find that there 
is substantial record evidence that the doctor for whom Respondent had 
previously worked stated that he neither wrote nor authorized the 
prescription, that this doctor notified his practice, and that the 
practice notified law enforcement. Id. I find that there is substantial 
record evidence that the prosecutor at Respondent's sentencing stated 
that

[[Page 50177]]

``[t]here's no evidence that there were any other forged prescriptions 
presented by . . . [Respondent].'' Id. I find that there is substantial 
record evidence that Respondent's attorney stated that Respondent 
``retained the [prescription] pad after she had left . . . [her prior 
medical office employer's] employ and basically she wrote prescriptions 
out for herself.'' Id. at 13. I further find that the ``Arrest 
Warrant'' for Respondent describes four allegations of Forgery in the 
First Degree, including presenting those forged prescriptions to a 
pharmacy for filling, spanning February 5, 2009, through November 11, 
2009. Id. at 31. I credit the statement of Respondent's attorney and 
the items addressed in the ``Arrest Warrant'' for Respondent. I 
conclude that the statement of Respondent's attorney, that Respondent 
``wrote prescriptions for herself,'' was made to ensure that all of 
Respondent's alleged criminality was subsumed in her guilty plea. Id. 
at 13. Given, among other reasons, that the statement of Respondent's 
attorney implicated Respondent in criminality in addition to the one 
instance to which she pled guilty through a ``negotiated plea,'' I 
credit the statement of Respondent's attorney, which I consider in my 
determination of Respondent's appropriate sanction. Id. at 10; supra 
section II.C.
    Based on substantial record evidence, I find that Respondent 
entered a negotiated guilty plea to Forgery in the First Degree, Ga. 
Code Ann. 16-9-1, a Georgia felony, and that the Court accepted her 
guilty plea on November 18, 2010. RFAAX 4, at 3-5, 9, 20, 26 
(hydrocodone prescription); see also RFAAX 5, at 3 (``forging 
prescriptions''). I find that there is substantial record evidence that 
the facts underlying Respondent's First-Degree Felony conviction 
include her having forged and presented for filling a controlled 
substance, hydrocodone, prescription for herself, and that the Court 
ordered Respondent discharged under the Georgia Probation for First-
Offenders Act. RFAAX 4, at 9-10; id. at 2.

F. Allegation That Respondent Materially Falsified Registration Renewal 
Applications (21 U.S.C. 824(a)(1))

    I find clear, unequivocal, and convincing evidence that, on 
November 18, 2010, the Honorable William H. McClain, Superior Court 
Judge of Douglas County, Georgia, found that Respondent pled guilty to 
one count of Forgery in the First Degree under Georgia law, ``freely 
and voluntarily, with a full knowledge, understanding in waiver of her 
rights, there's a factual basis, and no promises, threats or force has 
been used to induce'' her plea. Id. at 13; see also id. at 4-9. I find 
clear, unequivocal, and convincing record evidence that the facts 
underlying the Georgia felony to which Respondent pled guilty are that 
she forged and presented for filling a controlled substance 
(hydrocodone) prescription made out to herself on prescription paper 
belonging to a former physician employer. Id. at 9-10, 13. I find 
clear, unequivocal, and convincing record evidence that Judge McClain 
accepted her guilty plea, imposed sentence, and treated Respondent as a 
first offender on November 18, 2010. Id. at 15-16; see also id. at 20-
22. I find clear, unequivocal, and convincing record evidence that, on 
November 18, 2010, when Judge McClain asked her before imposing 
sentence if ``there [is] anything that . . . [she] would like to say,'' 
Respondent replied that she would ``[j]ust . . . enlighten people that 
nurse practitioners actually do have the authority and . . . [she] 
do[es] have the authority, . . . the license to write prescriptions for 
people in the State of Georgia as in many other states, and that is 
part of . . . [her] job.'' Id. at 14-15. I find clear, unequivocal, and 
convincing record evidence that Respondent also stated that she ``did 
the wrong thing in writing it for [her]self.'' Id. at 15. I find clear, 
unequivocal, and convincing record evidence that, when Judge McClain 
asked her whether she had ``any sort of drug abuse problem,'' 
Respondent answered, ``No, I do not.'' Id.
    I find clear, unequivocal, and convincing record evidence that, 
after her felony guilty plea and sentencing on November 18, 2010, 
Respondent submitted registration renewal applications to the Agency on 
December 31, 2011, on February 25, 2015, and on January 5, 2018. RFAAX 
1, at 1-10; see also RFAAX 3, at 1-2. I find clear, unequivocal, and 
convincing record evidence that, on those three registration renewal 
applications, Respondent answered ``no'' to the first Liability 
question that asked whether she had ``ever been convicted of a crime in 
connection with controlled substance(s) under state or federal law . . 
. or any such action pending?'' RFAAX 1, at 1-2, 4, 7, 10. I find 
clear, unequivocal, and convincing record evidence that Respondent 
admitted in her Written Statement that she answered ``no'' to this 
liability question ``in . . . [her] subsequent DEA renewal 
applications.'' RFAAX 3, at 1. I find clear, unequivocal, and 
convincing record evidence that Respondent stated that she provided 
this negative answer in ``December of 2011 . . . with the understanding 
that . . . [she] was not guilty of a felony substance control 
conviction.'' Id.
    I find clear, unequivocal, and convincing record evidence that, on 
June 25, 2013, the GBN placed Respondent's Georgia Nurse Practitioner 
license on probation for two years due to her ``fail[ure] to report her 
felony conviction to the . . . [GBN] within ten (10) days of such 
conviction.'' RFAAX 5, at 3-11, citing Ga. Code Ann. 43-1-27.\7\ I find 
clear, unequivocal, and convincing record evidence that, after the GBN 
placed her nurse practitioner license on probation on June 25, 2013, 
Respondent submitted registration renewal applications to the Agency on 
February 25, 2015 and on January 5, 2018. RFAAX 1, at 1-10; see also 
RFAAX 3, at 1-2. I find clear, unequivocal, and convincing record 
evidence that, on those two registration renewal applications, 
Respondent answered ``no'' to the third Liability question that asked 
whether she had ``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.'' RFAAX 1, at 1-2, 4, 7, 10. I find clear, unequivocal, 
and convincing record evidence that Respondent admitted in her Written 
Statement that she answered ``no'' to this liability question in 2015 
and in 2018. RFAAX 3, at 1. I find clear, unequivocal, and convincing 
record evidence that Respondent stated that she provided these two 
negative answers ``with the understanding because at that time . . . 
[her] nursing license was no longer under probation.'' Id.
---------------------------------------------------------------------------

    \7\ ``Any licensed individual who is convicted under the laws of 
this state, the United States, or any other state, territory, or 
country of a felony as defined in paragraph (3) of subsection (a) of 
Code Section 43-1-19 shall be required to notify the appropriate 
licensing authority of the conviction within ten days of the 
conviction. The failure of a licensed individual to notify the 
appropriate licensing authority of a conviction shall be considered 
grounds for revocation of his or her license, permit, registration, 
certification, or other authorization to conduct a licensed 
profession.''
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III. Discussion

A. The Controlled Substances Act

    Under the Controlled Substances Act (hereinafter, CSA), ``[a] 
registration . . . to . . . distribute[ ] or dispense a controlled 
substance . . . may be suspended or revoked by the Attorney General 
upon a finding that the registrant--(1) has materially falsified any 
application filed pursuant to or required by this subchapter or

[[Page 50178]]

subchapter II; [or] (2) has been convicted of a felony under . . . any 
. . . law of the United States, or of any State, relating to any 
substance defined in this subchapter as a controlled substance,'' among 
other reasons. 21 U.S.C. 824(a). The OSC alleged material falsification 
and felony conviction as the proposed bases for revocation of 
Respondent's registration. 21 U.S.C. 824(a)(1) and (2).

B. Allegation That Respondent Materially Falsified an Application (21 
U.S.C. 824(a)(1))

    As already discussed, I find clear, unequivocal, and convincing 
record evidence that Respondent submitted to the Agency three 
registration renewal applications containing a false answer to the 
first Liability question. Supra section II.F. Also, as already 
discussed, I find clear, unequivocal, and convincing record evidence 
that Respondent submitted to the Agency two registration renewal 
applications containing a false answer to the third Liability question. 
Id. My findings that Respondent submitted these false answers to the 
Agency stem from Respondent's conviction for violating a Georgia First-
Degree Felony when she forged and presented for filling a controlled 
substance prescription for herself. Id.; infra section III.C. Further, 
my fact findings directly implicate three of the factors I am 
statutorily mandated to consider as I act on applications for 
registration: The applicant's experience in dispensing controlled 
substances, the applicant's conviction record under Federal or State 
laws relating to the dispensing of controlled substances, and other 
conduct which may threaten the public health and safety. 21 U.S.C. 
823(f)(2), (3), and (5). Thus, Respondent's false responses on three 
registration renewal applications directly implicated my statutorily-
mandated analyses and decisions by depriving me of legally relevant 
facts when I evaluated those three registration renewal applications of 
Respondent. RFAAX 1, at 1-11; see also Frank Joseph Stirlacci, M.D., 85 
FR 45,229, 45,235 (2020). Accordingly, I find, based on the CSA and the 
analyses underlying multiple Supreme Court decisions explaining 
``materiality,'' that the five false Liability question responses 
Respondent submitted to the Agency in the three registration renewal 
applications at issue were material, and that the five false responses 
are grounds for the suspension or revocation of her registration. 21 
U.S.C. 824(a)(1); see Frank Joseph Stirlacci, M.D., 85 FR 45,235.
    According to the Written Statement, Respondent ``responded `No' to 
liability question 1 with the understanding that . . . [she] was not 
guilty of a felony substance control conviction.'' RFAAX 3, at 1. Due 
to the clear, unequivocal, and convincing record evidence, I do not 
credit this portion of Respondent's Written Statement.\8\ See, e.g., 
RFAAX 4, at 9 and RFAAX 5, at 3; see also infra section III.C.
---------------------------------------------------------------------------

    \8\ If Respondent intended to argue that her negotiated guilty 
plea in 2010 and her treatment as a first offender mean that she was 
not convicted of a First-Degree Felony, I reject her argument. The 
Agency established over thirty years ago, and recently reiterated, 
that a deferred adjudication is ``still a `conviction' within the 
meaning of the . . . [CSA] even if the proceedings are later 
dismissed.'' Kimberly Maloney, N.P., 76 FR 60,922, 60,922 (2011). In 
reaching this conclusion, the Agency explained that, ``[a]ny other 
interpretation would mean that the conviction could only be 
considered between its date and the date of its subsequent 
dismissal.'' Id. (citing Edson W. Redard, M.D., 65 FR 30,616, 30,618 
(2000)). The same reasoning applies to treatment as a first 
offender. I also note that the GBN Consent Order exists because 
Respondent ``failed to report her felony conviction to the Board 
within ten (10) days of such conviction as required by O.C.G.A. 
Sec.  43-1-27.'' RFAAX 5, at 3.
---------------------------------------------------------------------------

    Respondent's Written Statement also states that she ``answered `No' 
'' to the third Liability question ``with the understanding because at 
that time . . . [her] nursing license was no longer under probation.'' 
RFAAX 3, at 1. I do not credit this portion of Respondent's Written 
Statement because the third Liability question asks whether the 
applicant ``ever . . . had a state professional license . . . placed on 
probation.'' RFAAX 1, at 4; id. at 10 [emphasis added].

C. Allegation That Respondent Has Been Convicted of a Felony Related to 
Any Controlled Substance (21 U.S.C. 824(a)(2))

    As already discussed, I find substantial record evidence that 
Respondent entered a negotiated guilty plea to Forgery in the First 
Degree, Ga. Code Ann. 16-9-1, a Georgia felony, on November 18, 
2010.\9\ Supra section II.E. I also find substantial record evidence 
that the facts underlying Respondent's First-Degree Felony conviction 
include her having forged a controlled substance prescription for 
herself. Id.
---------------------------------------------------------------------------

    \9\ ``A person commits the offense of forgery in the first 
degree when with intent to defraud he knowingly makes, alters, or 
possesses any writing in a fictitious name or in such manner that 
the writing as made or altered purports to have been made by another 
person, at another time, with different provisions, or by authority 
of one who did not give such authority and utters or delivers such 
writing.'' Ga. Code Ann. Sec.  16-9-1 (West, Westlaw effective to 
June 30, 2012).
---------------------------------------------------------------------------

    Based on the facts I found in this matter, I conclude that 
Respondent has been convicted of a felony under a State law relating to 
a controlled substance. 21 U.S.C. 824(a)(2). First, to state the 
obvious, the state of Georgia used its First-Degree Felony Forgery 
statute to prosecute and convict Respondent of forging a controlled 
substance prescription even though that Georgia statute does not 
include the phrase ``controlled substance'' in its text. See n.9. 
Georgia's choice of this forgery statute shows that Respondent was 
convicted of a felony under a state law relating to any controlled 
substance. 21 U.S.C. 824(a)(2).
    Second, according to the Supreme Court, the phrase ``in relation 
to'' is interpreted expansively, and means ``with reference to'' or 
``as regards.'' Smith v. United States, 508 U.S. 223, 237 (1993). The 
Smith decision involved an offer to trade an automatic weapon for 
cocaine. 508 U.S. at 225. The decision addressed the question of 
whether the exchange of a firearm for cocaine constitutes using a 
firearm ``during and in relation to . . . [a] drug trafficking crime'' 
within the meaning of 18 U.S.C. 924(c)(1). Id. The Supreme Court's 
analysis cited prior Supreme Court and appellate court decisions 
interpreting the phrase ``in relation to'' and concluding that the 
phrase should be interpreted expansively. Id. at 237; see, e.g., 
District of Columbia v. Greater Washington Board of Trade, 506 U.S. 
125, 129 (1992) (``We have repeatedly stated that a law `relate[s] to' 
a covered employee benefit plan . . . `if it has a connection with or 
reference to such a plan.' . . . This reading is true to the ordinary 
meaning of `relate to' . . . and thus gives effect to the `deliberately 
expansive' language chosen by Congress.''); United States v. Harris, 
959 F.2d 246, 261 (D.C. Cir. 1992) (per curiam) (``The only limitation 
is that the guns be used ``in relation'' to the drug trafficking crime 
involved, which we think requires no more than the guns facilitate the 
predicate offense in some way.''); United States v. Phelps, 877 F.2d 28 
(9th Cir. 1989) (concluding that the situation was ``unusual'' and not 
covered, the court stated that ``the phrase `in relation to' is 
broad'').
    The Supreme Court also cited a dictionary definition in its 
analysis. 508 U.S. at 237-38. It stated that ``[a]ccording to 
Webster's, `in relation to' means `with reference to' or `as regards.' 
'' Id. at 237. It concluded, thus, that the phrase ``in relation to,'' 
at a minimum, ``clarifies that the firearm must have some purpose or 
effect with respect to the drug trafficking crime; its presence or 
involvement cannot be the result of accident or coincidence.'' Id. at 
238. The Court also stated that ``the gun at least must `facilitate[e], 
or ha[ve] the

[[Page 50179]]

potential of facilitating,' the drug trafficking offense.'' Id. 
Applying its analysis to the facts before it, the Court concluded that 
the use of the firearm ``meets any reasonable construction'' of ``in 
relation to'' because the gun was ``an integral part of the 
transaction.'' Id. I apply these conclusions of the Supreme Court as I 
analyze the record evidence before me.
    According to the facts I already found, Respondent used the 
prescription pad of a doctor at her former place of employment to write 
a schedule II controlled substance prescription for herself. RFAAX 4, 
at 9-10 and 13. My found facts also include that Respondent's 
registration did not have schedule II authority. RFAAX 1, at 1. As 
such, for Respondent to have any chance of obtaining a schedule II 
controlled substance from a pharmacy by her efforts alone, she had to 
present a prescription written on the prescription pad of, and 
purportedly signed by, a registrant with schedule II authority. As my 
found facts show, Respondent had already absconded with the 
prescription pad of a doctor at her former place of employment and used 
that prescription pad to prescribe a schedule II controlled substance 
for herself, including forging the name of the registrant to whom the 
prescription pad belonged. RFAAX 4, at 9-10 and 13. Under my found 
facts, therefore, the use of the forged prescription was ``an integral 
part of the transaction.'' Smith v. United States, 508 U.S. at 238. 
Based on the Supreme Court's explanation of ``in relation to,'' I 
conclude that Respondent's Georgia felony forgery conviction was ``with 
reference to'' and ``as regards'' a controlled substance and, 
accordingly, I also conclude that Respondent's felony forgery 
conviction satisfies the terms of 21 U.S.C. 824(a)(2).
    Third, prior Agency decisions have applied the felony conviction 
provision of 21 U.S.C. 824(a)(2) to circumstances similar to those in 
this matter. See, e.g., Samuel S. Jackson, D.D.S., 72 FR 23,848, 23,852 
(2007) (conspiracy to be an accessory after the fact); Clark G. 
Triftshauser, M.D., 67 FR 71,202, 71,203 (2002) (criminal possession of 
a forged instrument); Charles A. Buscema, M.D., 59 FR 42,857, 42,858 
(1994) (First-Degree Felony conviction for falsifying business records 
about the dispensing of controlled substances, but ultimately not 
finding for revocation); Lambert N. DePompei, M.D., 49 FR 37,862, 
37,863 (1984) (possession of false or forged prescriptions are ``all 
felony convictions relating to controlled substances''); Ontario Drugs, 
Inc., Fullerton-Kedzie Pharmacy, Inc., 46 FR 16,004, 16,005 (1981) 
(theft and forgery of controlled substance prescriptions). 
Consequently, my finding that Respondent's Georgia forgery felony 
guilty plea satisfies the terms of 21 U.S.C. 824(a)(2) is consistent 
with Agency decisions issued in the last forty years.
    For all of the above reasons, I conclude that the found facts in 
this matter meet the requirements of 21 U.S.C. 824(a)(2). Accordingly, 
I find that Respondent has been convicted of a felony related to any 
controlled substance. 21 U.S.C. 824(a)(2).
    In sum, I find that the record evidence supports two independent 
legal bases for the suspension or revocation of Respondent's 
registration--(1) five material falsifications in three registration 
renewal applications and (2) Respondent's conviction of a felony 
related to any controlled substance. 21 U.S.C. 824(a)(1) and (2).

IV. Sanction

    Where, as here, the Government presented two, independent bases for 
the suspension or revocation of Respondent's registration, and 
Respondent did not present evidence rebutting either of the two bases, 
it is then up to Respondent ``to assure the Administrator'' that she 
``can be entrusted with the responsibilit[ies] that accompany 
registration.'' White v. Drug Enf't Admin., 626 F. App'x 493, 496 (5th 
Cir. 2015); see also Jones Total Health Care Pharmacy, LLC v. Drug 
Enf't Admin., 881 F.3d 823, 830 (11th Cir. 2018) (quoting Akhtar-Zaidi 
v. Drug Enf't Admin., 841 F.3d 707, 711 (6th Cir. 2016)); MacKay v. 
Drug Enf't Admin., 664 F.3d 808, 816 (10th Cir. 2011) (quoting Volkman 
v. Drug Enf't Admin., 567 F.3d 215, 222 (6th Cir. 2009) quoting Hoxie 
v. Drug Enf't Admin., 419 F.3d 477, 482 (6th Cir. 2005)). As the Fifth 
Circuit also stated, ``[s]uch evidence includes acceptance of 
responsibility and a demonstration that the . . . [Respondent] `will 
not engage in future misconduct.' '' White v. Drug Enf't Admin., 626 F. 
App'x at 496; see also Pharmacy Doctors Enterprises, Inc. v. Drug Enf't 
Admin., 789 F. App'x, 724, 733 (2019) (citing Jones Total Health Care 
Pharmacy, LLC v. Drug Enf't Admin., 881 F.3d at 831 (citing MacKay v. 
Drug Enf't Admin., 664 F.3d at 820 (noting that past performance is the 
best predictor of future performance and, when a registrant has 
``failed to comply with . . . [her] responsibilities in the past, it 
makes sense for the agency to consider whether . . . [she] will change 
. . . [her] behavior in the future'') and Alra Labs., Inc. v. Drug 
Enf't Admin., 54 F.3d 450, 452 (7th Cir. 1995) (``An agency rationally 
may conclude that past performance is the best predictor of future 
performance.''))).
    The Agency has decided that the egregiousness and extent of 
misconduct are significant factors in determining the appropriate 
sanction. Garrett Howard Smith, M.D., 83 FR 18,882, 18,910 (2018) 
(collecting cases); Samuel Mintlow, M.D., 80 FR 3630, 3652 (2015) 
(``Obviously, the egregiousness and extent of a registrant's misconduct 
are significant factors in determining the appropriate sanction.''). 
The Agency has also considered the need to deter similar acts in the 
future by Respondent and by the community of registrants. Garrett 
Howard Smith, M.D., 83 FR 18,910; Samuel Mintlow, M.D., 80 FR 3652.
    In terms of egregiousness, the five instances of material 
falsification and the felony conviction go to the heart of the CSA: 
Non-compliance with the closed regulatory system devised to ``prevent 
the diversion of drugs from legitimate to illicit channels'' and not 
prescribing controlled substances in compliance with the applicable 
standard of care and in the usual course of professional practice. 
Gonzales v. Raich, 545 U.S. 1, 13-14, 27 (2005). These material 
falsifications and felony conviction alone support revocation.
    Further, the uncontroverted record evidence, including Respondent's 
admissions, shows that Respondent's forgery of controlled substance 
prescriptions for herself spanned 2008 and 2009. Supra sections II.C., 
II.D., II.E., and II.F. The record evidence includes five instances of 
Respondent's founded (including negotiated and admitted) or alleged 
forgery of a controlled substance prescription. Id. The admittedly and 
allegedly forged, self-prescribed controlled substance prescriptions, 
Vicodin/hydrocodone (4) and Tussionex Pennkinetic (1), all include 
hydrocodone, a highly abused schedule II controlled substance. Supra 
sections II.C., II.D., and II.E. In this regard, I note Respondent's 
sworn denials of ``any sort of drug abuse problem.'' Supra sections 
II.C. and II.F. I also note, though, that Respondent's current 
registration does not authorize her to issue schedule II controlled 
substance prescriptions, and that Respondent allegedly forged two, 
self-prescribed schedule II controlled substance prescriptions in one 
month. Supra sections II.A., II.C., and II.E.
    Respondent's submission does not address acceptance of 
responsibility. See supra section II.D. Indeed, Respondent does not 
even acknowledge the entirety of the OSC's charges against her. Her 
Written Statement begins by stating that she is writing it about 
``material falsification of renewal

[[Page 50180]]

applications for . . . [her] DEA license.'' RFAAX 3, at 1. At the end 
of her Written Statement, Respondent asks for ``a period of either 
probation or suspension with monitoring'' ``based on the circumstances 
in which . . . [she] unwittingly submitted the wrong responses on . . . 
[her] renewal applications.'' Id. at 2. In other words, Respondent does 
not even acknowledge that the OSC also proposed the revocation of her 
registration based on 21 U.S.C. 824(a)(2).
    Further, the focus of her Written Statement is that she ``made a 
very grave mistake which . . . [she] will forever regret.'' Id. at 1. 
It points out that she has ``undergone a lot of emotional stress 
regarding the risk . . . [she] placed . . . [her] career in.'' Id. The 
Written Statement, however, does not move beyond the impact her 
wrongdoing has on herself and her career. Id. at 1-2. It characterizes 
her wrongdoing as ``unwittingly submitting the wrong responses,'' not 
as violating the law and betraying the trust of her employer and the 
Agency. Id. at 2.
    Respondent's choice to submit a Written Statement, instead of 
taking advantage of her right to a hearing, means that she cannot 
answer questions about her admittedly and allegedly forged controlled 
substance prescriptions and whether she accepts responsibility for her 
wrongdoing. The areas of concern I have about her admitted and alleged 
violations include how many times she forged controlled substance 
prescriptions for herself, what controlled substances were involved, 
why she forged the prescriptions, and what she did with the controlled 
substances. The areas of concern I have about acceptance of 
responsibility include whether, and for what, Respondent unequivocally 
accepts responsibility. In other words, Respondent's recognition of 
having made a ``grave mistake'' that placed her career in risk, the 
resulting experience of ``a lot of emotional stress,'' and being 
``sorry'' that she placed herself ``in such a position'' do not 
constitute unequivocal acceptance of responsibility for her wrongdoing. 
All of the areas of concern to me remain unresolved.
    In sum, the record evidence raises, but does not answer, the extent 
and degree of Respondent's wrongdoing and whether Respondent 
unequivocally accepts responsibility for it as the Agency requires. 
Jeffrey Stein, M.D., 84 FR 46,968, 46,972-73 (2019) (unequivocal 
acceptance of responsibility); Jayam Krishna-Iyer, M.D., 74 FR 459, 463 
(2009) (collecting cases). These deficiencies are concerning. For 
example, they may mean that Respondent does not appreciate (1) the full 
extent of her wrongdoing and the (2) breadth of the harm her wrongdoing 
caused. I am also left wondering what Respondent learned from her 
wrongdoing, and whether Respondent has the resources to avoid future 
wrongdoing.
    For all of the above reasons, it is not reasonable for me, at this 
time, to trust that Respondent will comply with all controlled 
substance legal requirements in the future.\10\ Alra Labs., Inc. v. 
Drug Enf't Admin., 54 F.3d at 452 (``An agency rationally may conclude 
that past performance is the best predictor of future performance.''). 
Accordingly, I shall order that Respondent's registration be revoked, 
and that all pending applications to renew or modify Respondent's 
registration and any pending application for a new registration in 
Georgia, be denied.
---------------------------------------------------------------------------

    \10\ I do not consider remedial measures when a Respondent does 
not unequivocally accept responsibility. As discussed, the scope of 
Respondent's discussion of remedial efforts was limited and, 
therefore, unpersuasive and not reassuring.
---------------------------------------------------------------------------

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. 
MS1972101 issued to Uvienome Linda Sakor, N.P. Pursuant to 28 CFR 
0.100(b) and the authority vested in me by 21 U.S.C. 824(a) and by 21 
U.S.C. 823(f), I further hereby deny any pending application of 
Uvienome Linda Sakor, N.P., to renew or modify this registration, as 
well as any other pending application of Uvienome Linda Sakor, N.P. for 
registration in Georgia. This Order is effective October 7, 2021.

Anne Milgram,
Administrator.
[FR Doc. 2021-19194 Filed 9-3-21; 8:45 am]
BILLING CODE 4410-09-P