[Federal Register: February 12, 2004 (Volume 69, Number 29)]
[Notices]
[Page 7018-7022]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr12fe04-91]
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DEPARTMENT OF JUSTICE
Drug Enforcement Administration
Mark Wade, M.D.; Revocation of Registration
On October 4, 2002, the Deputy Assistant Administrator, Office of
Diversion Control, Drug Enforcement Administration (DEA), issued an
Order to Show Cause to Mark Wade, M.D. (Respondent) at his registered
location in Memphis, Tennessee. The Order to Show Cause notified the
Respondent of an opportunity to show cause as to why DEA should not
revoke his DEA Certificate of Registration, AW1747166, and deny any
pending applications for modification or renewal of that registration,
pursuant to 21 U.S.C. 824(a)(4) and 823(f), for reason that the
Respondent's registration was inconsistent with the public interest.
The Acting Deputy Administrator's review of the investigative file
reveals that the Order to Show Cause was received on behalf of the
Respondent on October 17, 2002. By letter dated October 28, 2002, the
Respondent directed a letter to the Hearing Clerk of the Office of
Administrative Law Judges notifying of his desire to waive his right to
a hearing in the matter. The Respondent also requested that the DEA
Administrator forgo revocation proceedings based on the anticipated
surrender of his DEA Certificate of Registration as part of a
sentencing proceeding in Federal court scheduled for January 9, 2003.
There is however, no information in the investigative file that the
Respondent has surrendered his DEA registration.
Therefore, finding that the Respondent has requested the waiver of
his right to a hearing and after considering material from the
investigative file in this matter, the Acting Deputy Administrator now
enters her final order without a hearing pursuant to 21 CFR 1301.43(e)
and 1301.46.
A review of the investigative file reveals that on or about
September 19, 1995, the Tennessee Board of Medical Examiners (Tennessee
Board) adopted a policy statement titled, ``Management of Prescribing
with Emphasis on Addictive and Dependence-Producing Drugs.'' Step One
advises: ``First and foremost, before [prescribing any drug], start
with a diagnosis which is supported by history and physical findings,
and by the results of any appropriate tests'' and ``do a workup
sufficient to support a diagnosis including all necessary tests.'' Step
Three of the policy statement specifies that ``Before beginning a
regimen of controlled drugs, [a determination should be made] through
trial or a documented history that non-addictive modalities are not
appropriate or they do not work.'' Step Four of the policy statement
cautions prescribing physicians to make sure they ``are not dealing
with a drug-seeking patient.''
On September 13, 2000, the Tennessee Board adopted a Position
Statement titled, ``Prerequisites to Prescribing Drugs In Person,
Electronically, Or Over the Internet.'' In its adoption of the position
statement, the Board outlined its interpretation of Tennessee Code
Annotated, Sections 63-6-214(b)(1), (4), and (12). The Tennessee
Board's statement posits in relevant part, that ``it shall be a prima
facie violation of T.C.A. 63-6-214(b)(1), (4), and (12) for a physician
to prescribe or dispense any drug to any individual, whether in person
or by electronic means or over the Internet or over telephone lines,
unless the physician has first done and appropriately documented, for
the person to whom a prescription is to be issued or drugs dispensed,
all of the following:
(a) Performed an appropriate history and physical examination;
(b) Made a diagnosis based upon the examinations and all
diagnostic and laboratory tests consistent with good medical care; and
(c) Formulated a therapeutic plan, and discussed it, along with
the basis for it and the risks and benefits of various treatment
options, a part of which might
[[Page 7019]]
be the prescription or dispensing drug, with the patient; and
(d) Insured the availability of the physician or coverage for the
patient for follow-up care.''
The Acting Deputy Administrator's review of the investigative file
reveals that William Stallknecht (Mr. Stallknecht), a pharmacist, was
part owner and operator of Pill Box Pharmacy (hereinafter referred to
as Pill Box), a drug store concern with two locations in San Antonio,
Texas. Included among the business operations of Pill Box was a Web-
based pharmacy with an Internet address of ``thepillbox.com,'' as well
as a related Web-based physician referral service which operated under
a separate Internet address.
DEA's investigation further revealed that following launch of his
Internet Web sites, Mr. Stallknecht then contracted with various
physicians around the country to conduct customer consultations. A
review of the investigative file further reveals that by 1998 or 1999,
Pill Box extended its Internet service to controlled substances.
Customers reportedly logged on to ``thepillbox.com'' Web site and
requested a physician consultation. Customers were then provided
questionnaires to complete and could request a physician consultation
via e-mail from the linked Web site, PHYSICIAN REFERRAL 2000, or by a
direct phone call to Pill Box employee, Brian Hildebrand (Mr.
Hildebrand). The customer would then be given a physician's telephone
number and instructed to contact the physician at a specific time and
date. The patient would telephonically contact the physician who in
turn would prescribe controlled substances for the customer after a
brief telephonic conversation, usually lasting ten (10) minutes or
less. These consultations did not include face-to-face physician-
patient interaction, a physical exam or any medical tests. Following
these brief consultations, the requested drug(s) would then be
dispensed and shipped to the customer by Pill Box.
DEA's investigation further revealed that when a Pill Box
contracting physician received a customer questionnaire, he would issue
prescriptions, generally for hydrocodone or a brand of hydrocodone, as
well as diazepam. In most cases, the Pill Box contracting physician
issued 100 dosage units of hydrocodone with three refills, lesser
amounts of Valium (with three refills), propoxyphene (both Schedule IV
controlled substances), or a similar drug.
The contracting physician would then send the prescriptions by
facsimile to the Pill Box location and the pharmacy would dispense the
drugs by overnight mail pursuant to the contracting physician's
prescription. Payment for the physician consultation, prescription
drugs, and shipping costs were all collected by the Pill Box via credit
card, money order, cash, or C.O.D. from the customer. DEA's
investigation further revealed that Pill Box collected approximately
$100.00 in physician consultation fees from each customer and the
pharmacy in turn made payments (or rebates as they were also called) to
contracting physicians based upon the number of prescriptions
authorized by the physician.
The Acting Deputy Administrator finds that the Respondent has been
registered as a practitioner with DEA since 1986, and has practiced
medicine in California (1986-1988), Louisiana (1988-1992), Florida
(1992-1995), and Arizona (1995-1999). The Respondent is currently
registered with DEA at a location in Memphis, Tennessee, and is also
licensed to practice medicine in that State. At the time of DEA's
investigation, the Respondent was a salaried employee at a cardiology
practice located in Memphis, where he earned a gross salary of roughly
$300,000 per year.
In response to information regarding the possible unlawful
distribution of controlled substances by Pill Box, on June 12, 2001,
law enforcement officers executed a Federal search of one of the
pharmacy's San Antonio locations. Computer records seized from the
pharmacy revealed that from January 1, 2000 through June 12, 2001, the
Respondent authorized a total of approximately 21,199 prescriptions
through Pill Box's Internet referral operation. Approximately 14,029 of
those prescriptions were for brand name Schedule III controlled
substances, including, Lorcet, Lortab, Vicodin and Zydone, as well as
generic hydrocodone products. Approximately 1,113 of those
prescriptions were for Valium.
In furtherance of its investigations of Pill Box and the
Respondent, on September 12, 2001, the Respondent was interviewed in
San Antonio, Texas by a representative of the United States Attorney's
Office, agents from the Criminal Investigation Unit of the Internal
Revenue Service (IRS) and DEA Diversion Investigators. During the
course of the interview, the Respondent disclosed that in 1999, he,
along with his family (wife and child) moved from Phoenix, Arizona to
Memphis, Tennessee. The Respondent stated that the move was prompted in
part by an unsuccessful and financially strapped medical practice group
in Phoenix (that later went bankrupt), and the Respondent's desire to
improve the financial situation of he and his family. DEA's
investigation revealed that at the time the Respondent moved to
Memphis, he was in debt to the IRS for about $131,000, and he had also
incurred substantial credit card debt.
The Respondent further disclosed that in or around September or
October of 1999, he found the Pill Box Web site and his attention was
drawn to the pharmacy's solicitation of physicians to conduct
consultations for customers. The Respondent subsequently responded to
the request, and a few months later, he was contacted by Mr. Hildebrand
concerning customer consultations for Pill Box. Following a discussion
regarding the pharmacy's consultation procedure, the Respondent decided
to join Pill Box as a consulting physician.
The Respondent further disclosed during the September 12, 2002,
interview with law enforcement personnel that he saw his association
with Pill Box as a ``moonlighting'' opportunity, and that he hoped
thereby to be able to pay off the indebtedness he had incurred.
Although he indicated his then understanding that the practice was
legal, DEA's investigation revealed that the Respondent nevertheless
did not consult with anyone, including the Tennessee Medical Board,
with questions about the legality of Internet consultations or
prescribing for Internet-based pharmacies.
Sometime within the first week of January, 2000, the Respondent
conducted his first telephone consultation on behalf of Pill Box. The
consultations were carried out at his residence, where Respondent had a
separate telephone line installed for that purpose. The Respondent
typically conducted consultations during the evenings after working
during the day at his cardiology practice. Shortly thereafter, the
Respondent began issuing prescriptions for controlled substances to
Internet customers.
During the September 12, 2002, interview, the Respondent admitted
being aware that a high percentage of the prescriptions he authorized
were for hydrocodone products, but added however, that the people for
whom the prescriptions were issued were ``between doctors or
insurance'', and he thought that they had a genuine need for these
drugs. The Respondent further added that he turned down a number of
people he thought were ``bogus.''
The Respondent further disclosed to law enforcement personnel that
he first
[[Page 7020]]
became aware of possible ``problems'' in the operation of Pill Box in
early 2001: He recalled hearing from Mr. Hildebrand that another
Internet referring physician for Pill Box was being investigated. The
investigative file however does not disclose the source of the
purported investigation. The Respondent also voiced concerns that
stemmed from complaints that he received from customers who stated that
they had not received the drugs he had prescribed and his suspicion
that Mr. Hildebrand was using Respondent's name for other prescriptions
not authorized by the Respondent. The Respondent informed law
enforcement personnel that he terminated his relationship with Pill Box
on February 5, 2001.
The Respondent further divulged that following the termination of
his business relationship with Pill Box, he went on to perform paid
consultations for three other Web-based pharmacies located in Florida,
Oklahoma, and Alabama. Each of the referenced pharmacies, like Pill
Box, facilitated the purchase of various drugs over the Internet by
visitors to their respective Web sites. With respect to the Oklahoma-
based Internet site, the Respondent told law enforcement authorities
that the pharmacist at that location agreed to accept faxed
prescriptions from the Respondent. However the arrangement was
discontinued in March 2001, when the Respondent was informed by the
pharmacist that the latter was under investigation.
DEA's investigation further revealed that the Respondent did not
perform an examination of any of the patients to whom he authorized
controlled substances through Pill Box, or any of the other online
pharmacies for which he provided consultations. Conversely, the
Respondent stated during his September 2001 interview with law
enforcement personnel that he typically spent thirty to forty-five
minutes with a new patient in his cardiology practice, excluding time
spent by office personnel taking a patient's weight, blood pressure,
and pulse. The Respondent added that a typical visit with an
established cardiology patient would be fifteen to twenty minutes. The
Respondent further contrasted his practice of cardiology with Internet
prescribing in that the services he provided to the internet customers
was meant only to be an interim measure.
The Respondent further informed law personnel that he once told Mr.
Hildebrand that he did not want consultations scheduled with customers
from Memphis, Tennessee because the Internet practice would be in
conflict with the Respondent's regular medical practice. The Respondent
further requested that Mr. Hildebrand not schedule the Respondent's
consultations with any customers in the State of Tennessee so as to
reduce his chance of ``getting into trouble'' with the state's medical
board.
The investigative file further reveals that in or around May 2000,
the Respondent was notified by an investigator for the Illinois Medical
Board that it was illegal for the Respondent to prescribe drugs to
patients in Illinois since the Respondent was not licensed to practice
medicine there. The Respondent later sent a letter to the Illinois
Medical Board stating that he would refrain from prescribing to
patients in that State. The investigative file further reveals that the
Respondent was informed by Mr. Hildebrand that other States such as
Kansas were ``cracking down,'' apparently on Internet-based prescribing
practices. As a result, the Respondent included Kansas as a State from
which he would not accept customer consultations on behalf of online
pharmacies.
On March 25, 2002, DEA's San Antonio District Office received a
written complaint statement and other documents regarding the
Respondent and Pill Box Pharmacy from ``NH'', an individual apparently
recovering from drug addiction. NHG informed DEA that she and her
daughter, ``AB'' had obtained via the Internet and telephonic
consultations, controlled substances (specifically Lortab) from the
Respondent and other Pill Box contracting physicians. NH further
divulged that appointments for physician consultations were arranged by
Mr. Hildebrand and prescriptions were then dispensed by Pill Box. With
respect to repayment arrangements for requested medications, NH wrote:
``In the beginning[,] you could use Visa, MasterCard, etc., but later
patients were told that this created a paper trail, therefore [Mr.
Hildebrand] could no longer accept anything but money orders.'' DEA
received further information that NH and AB have since undergone a drug
rehabilitation program after becoming addicted to the controlled
substances, including those received from Pill Box.
By letter dated December 20, 2001, the DEA San Antonio District
Office was informed by ``NB'' that her son ``PB'' had received more
than 100 dosage units of hydrocodone (Lortab) with two refills from a
prescription authorized by ``Dr. William Dale'', and the prescriptions
were filled by Pill Box. At the time PB received the prescription in
question, he resided in Birmingham, Alabama. There is no information in
the investigative file that the Respondent was either licensed to
practice medicine in Alabama or treated patients from that State. The
letter of NB went on to generally describe PB's resulting drug
addiction requiring hospitalization in an intensive care unit, and
subsequent care at a mental care facility. The letter further disclosed
that controlled substances received by PB eventually led to his
overdose of the drugs, and NB described PB as having ``damaged brain
cells'' and an ``uncertain prognosis.'' A review of prescription
information obtained by DEA from Pill Box revealed that on three
separate occasions from January to March 2001, the Respondent
authorized prescriptions for PB, each for 100 tablets of Lortab. These
controlled substances were subsequently delivered to PB by Pill Box.
The investigative file contains several additional instances where
individuals contacted DEA regarding difficulties they experienced
(i.e., drug abuse, dependency and addition) after obtaining controlled
substances authorized by the Respondent, and other Internet referring
physicians affiliated with Pill Box.
The Acting Deputy Administrator's review of the investigative file
further reveals a copy of a plea agreement listing the Respondent as a
defendant in a criminal action before the United States District Court
for the Western District of Texas. The plea agreement, which was signed
by the Respondent on October 4, 2002, set forth certain stipulations of
fact agreed upon by the parties, including findings that in 2000, the
Respondent began prescribing controlled substances for Pill Box'
Internet referral customers, who lived throughout the continental
United States and abroad, with ``no face-to-face contact with these
customers''; and, that in the course of a conspiracy with Pill Box and
William Stallknecht, and in relation to illegal prescriptions which
were filled by the pharmacy, the Respondent received a sum in excess of
$27,858.30 which constituted proceeds of the illegal dispensing of
42,750 dosages units of diazepam.
The plea agreement further referenced the Respondent's agreement
to waive indictment, and plead guilty to a charge set forth in a
criminal information, specifically, conspiracy to dispense Schedule IV
controlled substances in violation of 21 U.S.C., sections 846,
841(a)(1) and 841(b)(1)(D)(2). The Respondent also agreed to forfeit
and surrender is DEA Certificate of Registration at the time of
sentencing on the above referenced charge. However,
[[Page 7021]]
there is no information in the investigative file regarding the
imposition of any sentence upon the Respondent.
Pursuant to 21 U.S.C. 823(f) and 824(a)(4), the Acting Deputy
Administrator may revoke a DEA Certificate of Registration and deny any
pending application for renewal of such registration, if she determines
that the continued registration would be inconsistent with the public
interest. Section 823(f) requires that the following factors be
considered in determining the public interest:
(1) The recommendation of the appropriate State licensing board or
professional disciplinary authority.
(2) The applicant's experience in dispensing or conducting
research with respect to controlled substances.
(3) The applicant's conviction record under Federal or State laws
relating to the manufacture, distribution, or dispensing of controlled
substances.
(4) Compliance with applicable State, Federal, or local laws
relating to controlled substances.
(5) Such other conduct which may threaten the public health or
safety.
These factors are to be considered in the disjunctive; the Acting
Deputy Administrator may rely on one or a combination of factors and
may give each factor the weight she deems appropriate in determining
whether a registration should be revoked or an application for
registration denied. See Henry J. Schwartz, Jr., M.D., 54 FR 16422
(1989).
In this case, the Acting Deputy Administrator finds factors two,
three, four and five relevant to a determination of whether the
Respondent's continued registration remains consistent with the public
interest.
With regard to factor one, the recommendation of the appropriate
State licensing board or professional disciplinary authority, there is
no evidence in the investigative file that the Respondent has been the
subject of a State disciplinary proceeding, nor is there evidence
demonstrating that Respondent's medical license or State controlled
substance authority are currently restricted in any form. Nevertheless,
State licensure is a necessary, but no sufficient condition for
registration, and therefore, this factor is not dispositive. See e.g.,
Wesley G. Harline, M.D., 65 FR 5665 (2000) James C. LaJevic, D.M.D., 64
FR 55962 (1999).
With regard to factors two and four, the Acting Deputy
Administrator finds that the primary conduct at issue in this
proceeding (i.e., the unlawful authorization of controlled substance
prescriptions for use by Internet customers) relates to both the
Respondent's experience in dispensing controlled substances, as well as
his compliance with applicable State, Federal, or local laws relating
to controlled substances. Therefore, the Acting Deputy Administrator
combines these factors under 21 u.S.C. 823(f)(2) and (4). See, Service
Pharmacy, Inc., 61 FR 10791, 10795 (1996).
A DEA registration authorizes a physician to prescribe or dispense
controlled substances only within the usual course of his or her
professional practice. For a prescription to have been issued within
the course of a practitioner's professional practice, it must have been
written for a legitimate medical purpose within the context of a valid
physician-patient relationship. Paul J. Caragine, Jr., 63 FR 51592,
51600 (1998). Legally, there is absolutely no difference between the
sale of an illicit drug on the street and the illicit dispensing of a
licit drug by means of a physician's prescription. See Floyd A.
Santner, M.D., 55 FR 37581 (1990).
Factors two and four are relevant to the Respondent's authorization
of more than 14,000 prescriptions for Schedule III and IV controlled
substances from January 1, 2000 through June 12, 2001. The Acting
Deputy Administrator concludes from a review of the recor4d that the
Respondent did not establish a valid physician-patient relationship
with internet customers to whom he prescribed controlled substances.
See, Abel J. Sands, M.D., 59 FR 781 (1994). DEA has previously found
that prescriptions issued through a pharmacy Internet Web site are not
considered as having been issued in the usual course of medical
practice, in violation of 21 CFR 1306.04. Rick Joe Nelson, 66 FR 30752
(2001). The Acting Deputy Administrator also finds that the
Respondent's actions in this regard were not in compliance with State
law as his issuance of controlled substance prescriptions to internet
customers violated Tennessee State law. T.C.A. 63-6-214(b)(1), (4) and
(12).
In the instant case, the Respondent conducted scant consultations
(some lasting as little as five minutes) on behalf of a pharmacy that
offered access to controlled substances over the Internet. These
prescriptions were authorized without the benefit of face-to-face
physician-patient contact, physical exam or medical test. There is no
information in the investigative file demonstrating that the Respondent
even took the time corroborate responses to questionnaires that were
submitted by Pill Box's customers. Most, if not all of these customers
were outside of the area where the Respondent's primary medical
practice was located. Here, it is clear that the issuance of controlled
substance prescriptions to persons whom the prescribing physician has
not established a valid physician-patient relationship is a radical
departure from the normal course of professional practice.
With regard to factor three, applicant's conviction record under
Federal or State laws relating to the dispensing of controlled
substances, the record reveals that the Respondent has been convicted
of a felony related to controlled substances. On October 4, 2002, the
Respondent entered into a plea agreement on a Federal charge of
conspiracy to dispense Schedule IV controlled substances in violation
of 21 U.S.C. 846, 841(a)(1) and 841(b)(1)(D)(2). DEA has previously
held that guilty pleas to charges related to unlawful handling of
controlled substances are applicable to a finding under factor three.
Trudy J. Nelson, M.D., 66 FR 52941 (2001); John C. Turley, III, M.D.,
62 FR 14948 (1997); Yu-To Hsu, M.D., 62 FR 12840 (1997).
Regarding factor five, such other conduct which may threaten the
public health or safety, the Acting Deputy Administrator finds this
factor relevant to the Respondent's continued prescribing to Internet
customers, at a time when the Tennessee Medical Board adopted a policy
statement and a position statement designed to assist licensed
practitioners in the proper prescribing of dangerous controlled drugs.
Ironically, the Respondent is currently licensed to practice medicine
in a jurisdiction which sought to specifically address the proper
procedures for the issuance of prescriptions through electronic means
(i.e., via the Internet). While the record is unclear as to whether the
Tennessee Board's position statements on proper prescribing practices
were ever disseminated to the State's licensed physicians, the
Respondent demonstrated clearly that he possessed some knowledge of the
possible unlawful nature of his conduct, as evidenced by his statements
to law enforcement authorities of his desire to avoid legal
entanglements with the Tennessee Board. Factor five is further relevant
to the Respondent's continued authorization of prescriptions for
Internet customers even while receiving warnings from authorities in
Illinois and Kansas that the practice may be subject to restriction in
those jurisdictions. Factor five is also relevant to Respondent's
continued Internet consultations despite receiving information that
another Pill Box consulting physician as well as a
[[Page 7022]]
pharmacist in Oklahoma were under investigation for participating in
Internet drug distribution ventures. Despite the Respondent's
demonstrated awareness of the legal prohibitions surrounding his
prescribing on behalf of online pharmacies, there is no evidence in the
record that he ever sought guidance from the Tennessee Board or from
any law enforcement entity regarding the appropriateness of such
prescribing.
The Acting Deputy Administrator is deeply concerned about the
increased risk of diversion which accompanies Internet controlled
substance transactions. Given the nascent practice of cyber-
distribution of controlled drugs to faceless individuals, where
interaction between individuals is limited to information on a computer
screen or credit card, it is virtually impossible to insure that these
highly addictive, and sometimes dangerous products will reach the
intended recipient, and if so, whether the person purchasing these
products has an actual need for them. It is against this backdrop that
the Acting Deputy Administrator finds factor five relevant to
complaints received by the Respondent that Pill Box customers had not
received drugs that he authorized, and relevant to information received
by the Respondent that a Pill Box employee may have used the
Respondent's name for prescriptions not authorized.
Factor five is further relevant to the Respondent's apparent role
in exacerbating drug abuse and addition on the part of customers that
received controlled substances through Internet consultations. As noted
above, DEA received letters on behalf of individuals who became
severely impaired by controlled substances authorized by the Respondent
and distributed by Pill Box. The ramifications of obtaining dangerous
and highly addictive drugs with the ease of logging on to a computer
and the use of a credit card are disturbing and immense, particularly
when one considers the growing problem of the abuse of prescription
drugs in the United States.
In a 2001 report, the National Clearinghouse for Alcohol and Drug
Information estimated that 4 million Americans ages 12 and older had
acknowledged misusing prescription drugs. That accounts for 2% to 4% of
the population--a rate of abuse that has quadrupled since 1980.
Prescription drug abuse--typically of painkillers, sedatives and mood-
altering drugs--accounts for one-third of all illicit drug use in the
United States. Article by Melissa Healy, The Los Angeles Times,
December 1, 2003.
The Acting Deputy Administrator finds that with respect to Internet
transactions involving controlled substances, the horrific untold
stories of drug abuse, addiction and treatment are the unintended, but
foreseeable consequence of providing highly addictive drugs to the
public without oversight. The closed system of distribution, brought
about by the enactment of the Controlled Substances Act, is completely
compromised when individuals can easily acquire controlled substances
without regard to age or health status. Such lack of oversight
describes Pill Box's practice of distributing controlled substances to
indistinct Internet customers, and the Respondent's authorization of
those drugs on behalf of the pharmacy. Therefore, the Respondent's
actions in contributing to the abuse of controlled substances by
customers of Pill Box is relevant under factor five and further
supports the revocation of his DEA Certificate of Registration.
Factor five is further relevant to the Respondent's participation
in pharmacy Internet business ventures after terminating his business
relationship with Pill Box. As noted above, the Respondent demonstrated
some knowledge that his prescribing on behalf of Internet pharmacies
was unlawful. Nevertheless, following the termination of his business
relationship with Pill Box, the Respondent actively sought to associate
himself with other similar ventures, and admitted to providing
consultations to Internet referral customers on behalf of online
pharmacies in Florida, Oklahoma and Alabama.
It appears that the Respondent's actions in this regard were
motivated purely by profit. In his selfish pursuit of financial gain,
the Respondent demonstrated a cavalier disregard for controlled
substance laws and regulations and a disturbing indifference to the
health and safety of customers who purchased dangerous drugs through
the Internet. Such demonstrated lack of character and adherence to the
responsibilities inherent in a DEA registration show in no uncertain
terms that the Respondent's continued registration with DEA would be
inconsistent with the public interest.
Accordingly, the Acting Deputy Administrator of the Drug
Enforcement Administration, pursuant to the authority vested in her by
21 U.S.C. 823 and 824 and 28 CFR 0.100(b) and 0.104, hereby orders that
DEA Certificate of Registration AW174166, previously issued to Mark
Wade, M.D., be, and it hereby is, revoked. This order is effective
March 15, 2004.
Dated: January 20, 2004.
Michelle M. Leonhart,
Acting Deputy Administrator.
[FR Doc. 04-3127 Filed 2-11-04; 8:45 am]
BILLING CODE 4410-09-M