15 TYPES OF LICENSURE Permanent Licensure Temporary Licenses

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TYPES OF LICENSURE ��� Permanent Licensure ��� Temporary Licenses - Issued to Physicians in �Internships, Residencies and Fellowships ��� Conditional License- Interim License for New Graduates who are awaiting their Diploma and/or � 4 th year transcripts ��� Contiguous License - Temporary License for Interns, Residents or Fellows performing a Training Rotation from a Bordering State ��� Visiting Professor - Temporary license to teach or �lecture in a program sponsored by an accredited �medical school or accredited hospital in Missouri. 16

RENEWAL PROCESS ��� All licenses currently expire on January 31 of each year, �regardless of the date the license is issued. ��� Renewal Fee - $135 ��� Applications are mailed around December 1 st of each year �to the last address in the Board’s file. Failure to receive �the application, does not excuse you from filing your �application renewal prior to the expiration date. ��� Continuing Education: �– 50 hours of AMA Category 1 or AOA Category 1 A or � 2 A are required every two years. 17

NUMBER OF COMPLAINTS �The Board receives approximately 900 �complaints each year. ��� All complaints are investigated in some �manner. ��� The Board is required by law to review all �malpractice claims referred by the �Department of Insurance. This review �includes the subpoenaing of patient records 18

TYPES OF CASES ��� Competency ��� Quality of Care ��� Substance Abuse ��� Prescribing Violations ��� Billing Fraud ��� Felony Convictions ��� Sexual Misconduct ��� Action taken in another state 19

INVESTIGATIVE PROCESS �Complaint Received. ��� Reviewed by Board’s Complaint Review Committee �for the purpose of determining type of investigation to be conducted. ��� Licensee Notified (Except in cases involving Fraud or �Sexual Misconduct). ��� Licensee, Complainant and witnesses, if applicable, are interviewed and supporting documentation obtained. ��� Investigation Completed/Report Submitted. ��� Reviewed by Board. ��� Complaint Process takes approximately 6 -9 months to �complete. 20

DISCIPLINARY ACTIONS SINCE JANUARY 2008 NEWSLETTER Sam Martin, M. D. , Richmond Heights, MO � Cause of Discipline: 334. 100. 2(4), (13) and (23), RSMo � Licensee diverted Fentanyl from hospital waste and consumed it himself without a valid prescription; falsified patient records to divert Fentanyl from patient waste; and voluntarily surrendered his BNDD registration during the course of an investigation. � Board Action: License is placed on Probation for a period of ten (10) years. � Effective Date: 12/5/2007 Tonya E. Little, M. D. , Valley Park, MO � Cause of Discipline: 334. 100. 2(4) and (6), RSMo � Licensee failed to obtain CME's within time period established. � Board Action: License is Publicly Reprimanded. � Effective Date: 1/9/2008 21

DISCIPLINARY ACTIONS SINCE JANUARY 2008 NEWSLETTER Stevan M. Van Ore, M. D. , Fayetteville, AR � Cause of Discipline: 334. 100. 2(4)(h) and (8), RSMo � The Administrative Hearing Commission found cause to discipline license based upon the Arkansas Board's action due to Licensee's over-prescribing of scheduled medications for some of his patients. � Board Action: License is Revoked with no application for reinstatement for a period of two (2) years and one (1) day. � Effective Date: 1/30/2008 Cesar E. Maldonado, M. D. , El Paso, TX � Cause of Discipline: 334. 100. 2(4)(g) and (o), and (8), RSMo � The Board found cause to discipline license based upon the Suspension of Licensee's privileges from a hospital, indefinite suspension of license by the Texas Medical Board and violation of the Texas Probation order, all of which violated his Missouri Probation. � Board Action: License is Revoked with no application for reinstatement for a period of two (2) years and one (1) day. 22