STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL ) REGULATION, )

)

Petitioner, )

)

vs. ) CASE NO. 93-1520

)

ANAND LATTANAND, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, final hearing in the above-styled case was held in Tampa, Florida, on October 8, 1993, before Robert E. Meale, Hearing Officer of the Division of Administrative Hearings.

APPEARANCES

The parties were represented at the hearing as follows: For Petitioner: Sandra A. Wolpe, Senior Attorney

Department of Business and

Professional Regulation

6261 Northwest 6th Way, Suite 110 Fort Lauderdale, Florida 33309

For Respondent: Veronica E. Donnelly

Greene Donnelly

100 North Tampa Street, Suite 2825 Tampa, Florida 33602

STATEMENT OF THE ISSUE

The issue in this case is whether Respondent is guilty of sexual misconduct with patients.

PRELIMINARY STATEMENT

By Administrative Complaint filed May 15, 1992, Petitioner alleges that, on May 24, 1990, Respondent examined the skin of a janitor cleaning Respondent's offices and squeezed and stroked the janitor's penis for the sole purpose of engaging or trying to engage the janitor in sexual activity. Count I of the Administrative Complaint alleges that this activity violates Section 458.331(1)(j), Florida Statutes, which prohibits a physician from exercising influence within the physician-patient relationship for the purpose of engaging the patient in sexual activity. Count II alleges that this activity also violates Section 458.331(1)(x), which prohibits a physician from violating any provision of Chapter 458, rule, or lawful order of the board or Petitioner.

Counts III and IV allege violations of the same statutes in connection with Respondent's treatment of a patient to whom he was rendering dermatological care. The Administrative Complaint alleges that on June 11 and 18, 1991, Respondent massaged the patient's penis after learning that the patient had been experiencing difficulty maintaining erections.

At the commencement of the hearing, Petitioner moved to amend the Administrative Complaint to correct certain references to the dates on which the events allegedly took place. Although alleging that three incidents involving patient P. T. took place, Counts III and IV referred only to June 11 and 18.

The motion to amend sought leave to change certain references from June 11 to June 8. The motion was granted over Respondent's objection.

During the hearing, the hearing officer notified the parties that he would take official notice of the Physicians' Desk Reference.

At the hearing, Petitioner called four witnesses and offered into evidence five exhibits. Respondent called three witnesses and offered into evidence seven exhibits. By Order entered October 12, 1993, the parties were given leave to file additional exhibits following the hearing, and the parties subsequently filed as exhibits five deposition transcripts. On November 17, 1993, Respondent filed objections to the use of Dr. Sprehe's deposition for any purpose other than mitigation. The objection is sustained. Subject to this condition, all exhibits were admitted.

The transcript was filed October 28, 1993. Each party filed a proposed recommended order. Rulings on the proposed findings are in the appendix.

FINDINGS OF FACT

1. At all material times, Respondent has been a licensed physician, holding license number ME 0034105. From June, 1985, to present, Respondent has been in private practice, specializing in dermatology.

   
   

2. Respondent has limited professional experience regarding sexually transmitted diseases. Over 25 years ago, he published two articles in the Thai language in his native Thailand, where he graduated from medical school in 1959. From 1981-1988, Respondent delivered 15 hours of lectures to third-year medical students at Temple University, at which Respondent was Director of the Dermapathology Laboratory during that timeframe. He was also an associate professor of dermatology at Temple University hospital during approximately the same time.

   
   

3. After leaving Temple in mid-1988, Respondent became an associate professor of medicine in the Division of Dermatology in the Department of Internal Medicine at the University of South Florida. He held this position for one year.

   
   

4. In 1990, Respondent regularly visited the Bay Pines VA Hospital to see outpatients twice weekly. During these visits, Respondent would see 4-5 patients a day in the outpatient clinic and then consult with 5-15 patients in the wards.

5. On May 24, 1990, Respondent had completed seeing patients in the outpatient clinic at about 5:30 pm and was preparing to conduct his consultations in the ward. A janitor, L. K., was performing cleanup services in the clinic. He saw the door open to Respondent's office and Respondent sitting at his desk. L. K. asked if he could come in and empty the wastebasket, and Respondent said he could.

   
   

6. After leaving the office, L. K. went around to the rest of the offices and collected their trash. Returning to the point where he began, which was near Respondent's office, L. K., passing Respondent who was talking to a nurse, entered the office and began to clean Respondent's sink.

   
   

7. Respondent returned to his office and initiated conversation with the janitor by asking him how old he was and remarking that his skin looked older than it should. Respondent began to examine L. K.'s skin, first on his neck and then his arms. Respondent asked L. K. if he had any moles or dark spots and asked if L. K. wanted Respondent to examine his back. Respondent and L. K. were alone in the office.

   
   

8. L. K. unzipped his shirt, which was part of his janitorial uniform. While examining L. K.'s back, Respondent asked if he had had any moles removed.

   L. K. indicated that he had had some moles removed from his arms.

   
   

9. L. K. had a rash on his side. Respondent asked if he had the rash on his legs. L. K. said yes and Respondent offered to check it out if L. K. wanted him to. L. K. said that he would.

   
   

10. As L. K. unfastened his pants, Respondent shut the door. While L. K. stood in his underpants, Respondent examined his legs and thighs while seated in a chair. Respondent then pulled L. K.'s underwear down and started to feel L. K.'s scrotum. Respondent then took L. K.'s penis between two fingers and his thumb and began to pull on it. He asked if L. K. had any discharge, and L. K. responded by saying that he had had a urinary tract infection several months ago, but it had been treated and cleared up.

    
    

11. Respondent went to his desk and got polysporin and squeezed some of the ointment on his fingers. At no point during the occurrence was Respondent wearing gloves. He then applied the ointment to the head of L. K.'s penis. Then Respondent rubbed the ointment along the length of the penis. Finally, Respondent pulled on the penis two or three times with his hand.

    
    

12. At this point, L. K. pulled away and told the doctor that he had to get back to work. Respondent asked L. K. for whom he worked, and L. K. named his supervisor. Respondent said that he would contact him and arrange an appointment. Respondent added that L. K. should not tell anybody of the occurrence.

    
    

13. Respondent then left the office for consultations. At this point, Respondent still did not know the name of L. K., had not prepared or obtained a chart for L. K., had not recorded any medical findings, had not arranged any laboratory tests, and had not advised L. K. that he should undergo any medical follow-up.

    
    

14. Respondent's touching of L. K.'s genital area was done for the sexual gratification of Respondent. L. K.'s consent to an examination of his genital area was under the fraudulently induced impression that Respondent would conduct

    an examination exclusively for medical purposes and medically treat a discharge that in fact did not exist. The touching was not in any way for the purpose of medical diagnosis or treatment.

    
    

15. On June 4, 1991, P. T. visited Respondent's office to have lesions on his scalp examined and removed. Respondent examined some lesions and excised several by freezing. Respondent's nurse or assistant was present during the examination and treatment of the lesions.

    
    

16. After the treatment had been concluded and the nurse or assistant had left the examination room, Respondent asked P. T. if he was experiencing any side effects from certain medications that he had been taking for over five years. P. T. had been taking Tofranil (50 mg daily) and Serax (15 mg daily) as a result of a serious depressive episode that he had suffered about 20 years earlier.

    
    

17. P. T. replied that he had suffered from sexual dysfunction, which he believed resulted from taking the medication. He complained of a loss of interest in sex and an inability to attain or maintain an erection.

    
    

18. Respondent told P. T. that, if he kept it a secret, Respondent would try to help him with the sexual problems. Respondent explained that the assistance might be misconstrued by others. P. T. agreed. Respondent's assistance consists exclusively of the findings set forth in the following paragraphs. At no time did Respondent take any history or conduct any tests to determine the etiology of the sexual problems of which P. T. was complaining, nor did Respondent ever note in P. T.'s records any examination, diagnosis, or treatment concerning P. T.'s sexual complaints.

    
    

19. After P. T. agreed to accept Respondent's help, Respondent locked the door to the examination room and asked P.T. to drop his pants. After P. T. did so, Respondent began to massage the area of P. T.'s scrotum. After about five minutes, P. T. began to get an erection. Shortly thereafter, Respondent stopped, advised P. T. to practice this procedure, and told P. T. to make another appointment.

    
    

20. At no point during this or the ensuing two office visits did Respondent discuss with P. T. other possible causes of his sexual problems or other diagnostic work that could be undertaken to identify or rule out these causes. Respondent did not touch P. T.'s genitalia so as to demonstrate some technical form of stimulation. Due to Respondent's position bent over in front of the standing patient, P. T. could not see what Respondent was doing. And Respondent did not, while touching P.T.'s genitals or at any other time, explain what he was doing. Respondent did not wear gloves during any of the touchings.

    
    

21. On June 11, 1991, P. T. returned to Respondent's office. During the course of a dermatological examination, Respondent found a growth on P. T.'s chest that Respondent advised should be removed. P. T. agreed and the growth was removed during that visit. The nurse or assistant who had been in the room during the examination and treatment then left the room with the specimen.

    
    

22. At this point, Respondent asked P. T. if he was ready for his other treatment. Pleased with the results so far, P. T. agreed and Respondent locked the door. Respondent again manipulated P. T.'s genitals and, after awhile, stopped and told P. T. to make another appointment.

23. On June 18, 1991, P. T. appeared at the office for his third visit. After receiving treatment for the head lesions, which had largely healed by then, P. T. remained alone in the examination room with Respondent after the nurse or assistant had left. Respondent then asked P. T. to remove his clothes. As P.T. began to do so, Respondent placed his hand on his genitals and motioned toward P. T. P. T. cried out, "Not with me you don't" and hurriedly left the examination room. He ran down the hall, pulling up and fastening his pants, with Respondent behind him saying that there would be no charge for the visit.

    
    

24. Respondent's touching of P. T.'s genital area was done for the sexual gratification of Respondent. P. T.'s consent to an examination of his genital area was under the fraudulently induced impression that Respondent would medically diagnose and treat P. T.'s problem regarding a loss of erections. The touching was not in any way for the purpose of medical diagnosis or treatment. Respondent never pursued appropriate diagnostic means before attempting the purported treatment.

    
    

25. P. T.'s physiological response no more characterizes the touching or advice of Respondent as medical treatment than P.T.'s trick-induced consent characterizes his participation in these occurrences as knowing and voluntary. The reactions of a vulnerable patient have no bearing on the finding that Respondent conducted these touchings solely for the purpose of his sexual gratification.

    
    

    CONCLUSIONS OF LAW

    
    

26. The Division of Administrative Hearings has jurisdiction over the subject matter and the parties. Section 120.57(1), Florida Statutes. (All references to Sections are to Florida Statutes. All references to rules are to the Florida Administrative Code.)

    
    

27. Section 458.331(1)(j) provides that Petitioner may discipline a physician for

    
    

    Exercising influence within a patient- physician relationship for purposes of engaging a patient in sexual activity. A patient shall be presumed to be incapable of giving free, full, and informed consent to sexual activity with his physician.

    
    

28. Petitioner must prove the material allegations against Respondent by clear and convincing evidence. Ferris v. Turlington, 510 So. 2d 292 (Fla. 1987). Section 458.331(3) provides that the standard of clear and convincing evidence is applied in proceedings involving revocation or suspension; otherwise, the standard is a mere preponderance of the evidence. All of the findings in this recommended order are based on the standard of clear and convincing evidence.

    
    

29. Petitioner has proved that Respondent exercised influence with a patient-physician relationship for the purpose of engaging L. K. and P. T. in sexual activity. The second sentence of Section 458.331(1)(j) is irrelevant because there was no informed consent on the part of either patient, each of whom was tricked by Respondent into believing that he was touching their genitals for the purpose of medical diagnosis and treatment. Even though Respondent never created medical records for L. K., he nevertheless qualifies as a patient once Respondent, under the guise of medical diagnosis and treatment,

    initiates what reasonably appears to L. K. to be a medical examination and treatment. Section 458.331(1)(j) best describes the conduct of which Respondent has been proved guilty, so it is unnecessary to consider whether the same actions violated other provisions of law.

    
    

30. Section 458.331(2) provides that the Board of Medicine may discipline a physician found to have violated one or more provisions of Section 458.331(1). The penalties include revocation, suspension, restriction of practice, imposition of an administrative fine of not more $5000 per count or separate offense, issuance of a reprimand, and placement of the physician on probation.

    
    

31. Rule 21MM-20.001(2)(j) states that the appropriate penalties for a violation of Section 458.331(1)(j) are revocation, a one-year suspension, and an administrative fine from $250 to $5000.

    
    

32. Rule 21MM-20.001(3) lists among aggravating and mitigating factors, which may warrant deviation from the above- stated penalties, the exposure of the patient to injury or potential injury, including but not limited to physical injury; Respondent's legal status at the time of the offense; the number of counts or separate offenses; Respondent's disciplinary history; and the pecuniary benefit to Respondent.

    
    

33. The evidence in the record is insubstantial concerning emotional or psychological injury to L. K. and P. T. There is no evidence of physical injury. There is no evidence of findings or admissions of guilt involving other offenses by Respondent. However, there are four separate offenses: one with L.

K. and three with P. T.

RECOMMENDATION

Based on the foregoing, it is hereby

RECOMMENDED that the Board of Medicine enter a final order finding Respondent guilty of four separate violations of Section 458.331(1)(j), Florida Statutes, and imposing an administrative fine of $20,000 ($5000 per separate offense) and suspending Respondent's license for two years; provided, however, the two- year suspension shall be reduced to the longer of six months or the point (but not more than two years) at which Respondent successfully completes such educational and ethical coursework and psychological and psychiatric counseling and treatment as the Board requires and obtains a certificate from a suitable professional that he is safe to return to the practice of medicine.

Following the expiration of the suspension, Respondent's license shall be restricted, for such term as the Board requires, so that Respondent must always have an employee present when he examines, diagnoses, treats, or otherwise meets with a patient.

ENTERED on December 30, 1993, in Tallahassee, Florida.

ROBERT E. MEALE

Hearing Officer

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, FL 32399-1550

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings on December 30, 1993.

APPENDIX

Rulings on Petitioner's Proposed Findings

1-20: adopted or adopted in substance.

21: rejected as irrelevant and subordinate. 22-23: adopted or adopted in substance.

24-40: adopted or adopted in substance.

Rulings on Respondent's Proposed Findings

1-8 (sentences one and three): adopted or adopted in substance.

8 (sentence two): rejected as unsupported by the appropriate weight of the evidence.

9-10: adopted or adopted in substance.

11: rejected as unsupported by the appropriate weight of the evidence.

Respondent asked L. K. if Respondent would remove his shirt.

12-13: rejected as unsupported by the appropriate weight of the evidence except that L. K. lowered his pants.

14: adopted.

15: rejected as irrelevant.

16: adopted except that his testimony concerning discharge is rejected as unsupported by the appropriate weight of the evidence.

17: rejected as recitation of evidence.

18-19: rejected as irrelevant and, as to 19, rejected as unsupported by the appropriate weight of the evidence.

20-21: rejected as irrelevant.

22-23 (as to mistake): rejected as unsupported by the appropriate weight of the evidence.

24-26 (sentences one and two): rejected as unsupported by the appropriate weight of the evidence.

26 (sentence three)-28 (sentence one): adopted in substance.

28 (sentences two through four): rejected as unsupported by the appropriate weight of the evidence.

29-30: adopted.

31-32 (to extent of implication that L. K. misperceived the purpose of the touching of his genitals): rejected as unsupported by the appropriate weight of the evidence.

33-40: rejected as subordinate.

41-42: rejected as recitation of testimony.

43-44: rejected as subordinate.

45 (sentence one): rejected as recitation of evidence.

45 (sentence two)-46: rejected as unsupported by the appropriate weight of the evidence.

47-48: rejected as subordinate. 49-50: rejected as irrelevant.

51-53: rejected as unsupported by the appropriate weight of the evidence. 54-69: rejected as subordinate, irrelevant, and unnecessary. Additionally,

proposed findings concerning the conclusions that Respondent's problems were due to miscommunications arising out of cultural differences--if offered to rebut an ultimate finding of liability rather than, as suggested by the heading on p. 11, as mitigation--are rejected as unsupported by the appropriate weight of the evidence.

70-73: adopted or adopted in substance. 74-75: rejected as irrelevant.

76-77: rejected as unsupported by the appropriate weight of the evidence and irrelevance.

78-79 (sentence one): rejected as unsupported by the appropriate weight of the evidence.

79 (sentence two): rejected as unsupported by the appropriate weight of the evidence. The consent was obtained by trick.

80: rejected as irrelevant.

81 and 92: rejected as unsupported by the appropriate weight of the evidence to the extent of the implication that the touching of the penis was for medical, not sexual, purposes.

82: rejected as recitation of testimony and as unsupported by the appropriate weight of the evidence.

83: rejected as unsupported by the appropriate weight of the evidence. 84: adopted in substance.

85-86: rejected as unsupported by the appropriate weight of the evidence.

87 and 89-90: adopted.

88: rejected as irrelevant.

91: rejected as recitation of testimony.

93-96: rejected as unsupported by the appropriate weight of the evidence. 97-99: rejected as irrelevant.

100: adopted in substance. 101: rejected as irrelevant.

102-03 (sentence one): rejected as legal argument.

103 (sentence two): rejected as unsupported by the appropriate weight of the evidence.

104-05: rejected as unsupported by the appropriate weight of the evidence. 106-12: rejected as subordinate, irrelevant, and unnecessary.

Additionally, proposed findings concerning the conclusion that Respondent could practice with reasonable safety--if offered to rebut an ultimate finding of liability rather than, as suggested by the heading on p. 21, as mitigation--are rejected as unsupported by the appropriate weight of the evidence.

COPIES FURNISHED:

Veronica E. Donnelly Greene Donnelly

100 N. Tampa St., Ste. 2825 Tampa, FL 33602

Attorney Sandra A. Wolpe 6261 NW 6th Way, Ste. 110 Ft. Lauderdale, FL 33309

Alex D. Barker, Senior Attorney

Department of Business and Professional Regulation 7960 Arlington Expressway, Suite 230

Jacksonville, FL 32211

Dorothy Faircloth, Executive Director Board of Medicine

1940 North Monroe Street Tallahassee, FL 32399-0792

Jack McRay, General Counsel

Department of Business and Professional Regulation 1940 North Monroe Street

Tallahassee, FL 32399-0792

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions to this Recommended Order. All agencies allow each party at least 10 days in which to submit written exceptions. Some agencies allow a larger period within which to submit written exceptions. You should contact the agency that will issue the final order in this case concerning agency rules on the deadline for filing exceptions to this Recommended Order. Any exceptions to this Recommended Order should be filed with the agency that will issue the final order in this case.

=================================================================

AGENCY FINAL ORDER

=================================================================

STATE OF FLORIDA

DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION BOARD OF MEDICINE

DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION,

Petitioner,

vs. DBPR CASE NOS. 91-04376 &

91-09433

ANAND LATTANAND, DOAH CASE NO. 93-1520 LICENSE NO. ME 0034105

Respondent.

/

FINAL ORDER

THIS MATTER was heard by the Board of Medicine (hereinafter Board) pursuant to Section 120.57(1)(b)10., Florida Statutes, on February 5, 1994, in Tampa, Florida, for consideration of the Hearing Officer's Recommended Order (Attached as App. A) in the case of Department of Business and Professional Regulation v. Anand Lattanand, M.D. At the hearing before the Board, Petitioner was represented by Larry G. McPherson, Jr., Chief Medical Attorney. Respondent appeared before the Board of Medicine with Veronica E. Donnelly, Esquire. Upon consideration of the Hearing Officers Recommended Order after review of the complete record and having been otherwise fully advised in its premises, the Board makes the following rulings, findings and conclusions:

RULINGS ON EXCEPTIONS

Respondent filed exceptions (Attached as App. B) to the Recommended Order of the Hearing Officer. Pursuant to Rule 61F6-18.004(2) and (3), F.A.C., the Board reviewed each exception and ruled explicitly on each exception. The Board ruled as follows:

1. The first exception and its subparts are rejected by the Board. They each go to procedural matters within the purview of the Hearing Officer and the Board accepts the actions of the Hearing Officer as correct.

   
   

   1. Rejected for the reasons set forth in Petitioner's response to the exceptions. (Attached as App. C)

      
      

   2. Rejected for the reasons set forth in Petitioner's response to the exceptions. (Attached as App. C)

      
      

   3. Rejected for the reasons set forth in Petitioner's response to the exceptions (Attached as App. C) and because of the testimony in the record of Dr. Jones which provides competent substantial evidence to support the recommended finding of fact in paragraph 14.

   4. Rejected for the reasons set forth in Petitioner's response to the exceptions. (Attached as App. C)

      
      

   5. Accepted and the words "nor did Respondent ever note in P.T.'s records any examination, diagnosis, or treatment concerning P.T.'s sexual complaints" shall be deleted from paragraph 18. of the Recommended Order because they are not supported by competent substantial evidence in the record.

      
      

   6. Rejected for the reasons set forth in Petitioner's response to the exceptions. (Attached as App. C)

      
      

   7. Accepted because the finding as recommended is not supported by competent substantial evidence. Paragraph 21. shall be amended to read:

      
      

      1. On June 11, 1991, P.T. returned to Respondent's office. During the course of a previous dermatological examination, Respondent found a growth on P.T.'s chest that Respondent advised should be removed.

         P.T. agreed and the growth was removed during this second visit. The nurse or assistant who had been in the room during the examination and treatment then left the room with the specimen.

         
         

   8. Rejected for the reasons set forth in Petitioners response to the exceptions (Attached as App. C) and because the finding set forth in paragraph

      1. of the Recommended Order involves a determination of the credibility of witnesses which is reserved to the Hearing Officer.

         
         

   9. Rejected for the reasons set forth in Petitioner's response to the exceptions (Attached as App. C) and because the finding set forth in paragraph

      1. of the Recommended Order involves a determination of the credibility of witnesses which is reserved to the Hearing Officer.

         
         

   10. Rejected for the reasons set forth in Petitioner's response to the exceptions (Attached as App. C) and because the findings set forth in paragraphs

   1. & 25. of the Recommended Order involve determinations of the credibility of witnesses which is reserved to the Hearing Officer.

      
      

      Furthermore, Respondent's Motion to Strike Petitioner's responses to the exceptions filed by Respondent was denied as was Petitioner's Motion to Increase Penalty.

      
      

      FINDINGS OF FACT

      
      

      1. The Hearing Officer's Recommended Findings of Fact are approved and adopted and are incorporated herein by reference with the changes set forth above in the Board's ruling on exceptions to paragraph 18. and 21. of the Recommended Order.

         
         

      2. There is competent, substantial evidence to support the Board's findings herein.

CONCLUSIONS OF LAW

1. The Board has jurisdiction over the parties and subject matter of this case pursuant to Section 120.57 and Chapter 458, Florida Statutes.

   
   

2. The findings of fact set forth above do establish that Respondent has violated Section 458.331(1)(j), F.S. a set forth in the recommended Order.

DISPOSITION

In light of the foregoing Findings of Fact and Conclusions of Law the Board hereby determines that pursuant to Rule 61F6-20, Florida Administrative Code, the penalty recommended by the Hearing Officer is not quite appropriate as set forth in the Recommended Order. The Board specifically finds as set forth in the record of this case that Respondent's actions were predatory in nature, they occurred outside the scope of his area of medical practice of dermatology, and that the actions with the second patient occurred after Respondent had made initial contact with the Physician Recovery Network (PRN).

WHEREFORE, it is found, ordered and adjudged that the Respondent has in four instances violated Section 458.331(1)(j), F.S., and pursuant to Rule 61F6- 20, Respondent shall pay an administrative fine of $20,000.00 ($5,000.00 per separate offense) with said fine being payable to the Executive Director of the Board of Medicine within thirty (30) days of the effective date of this Final Order. Furthermore, Respondent's license to practice medicine in Florida shall be SUSPENDED until such time as Respondent enters into a contract with PRN and until such time as PRN recommends to the Board that Respondent is ready to resume practice. Upon reinstatement, Respondent's license shall be restricted for such term as shall be set by the Board at that time and so that Respondent will always have an employee, licensed by a professional regulatory board in Florida, present when he examines, diagnoses, treats, or otherwise meets with a patient.

This Final Order becomes effective upon its filing with the Clerk of the Department of Business and Professional Regulation.

NOTICE

The parties are hereby notified pursuant to Section 120.59(4), Florida Statutes, that an appeal of this Final Order may be taken pursuant to Section 120.68, Florida Statutes, by filing one copy of a Notice of Appeal with the Clerk of the Department of Business and Professional Regulation and one copy of a Notice of Appeal with the required filing fee with the District Court of Appeal within thirty (30) days of the date this Final Order is filed.

DONE and ORDERED this 5th day of April, 1994.

BOARD OF MEDICINE

RICHARD JAMES CAVALLARO, M.D. VICE-CHAIRMAN

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order and its attachments have been forwarded by U.S. Mail to ANAND LATTANAND, M.D. c/o Veronica E. Donnelly, Esquire, 100 North Tampa Street, Suite 2825, Tampa, Florida 33602 and to Robert E. Meale, Hearing Officer, Division of Administrative Hearings, the DeSoto Building 1230 Apalachee Parkway, Tallahassee, Florida 32399-1550, and by hand delivery to Larry G. McPherson, Jr., Chief Medical Attorney, Department of Business and Professional Regulation, 1940 North Monroe Street, Tallahassee, Florida 32399-0792 on this day of

, 1994.

[Certificate of Service filed with DOAH undated and unsigned]

AMENDED CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing Order has been provided by certified mail to Anand Lattanand, M.D., 3450 E. Fletcher Ave., Tampa, FL 33613-4648, and to Veronica E. Donnelly, Esq., 100 North Tampa St., Suite 2825, Tampa, FL 33602, and to Robert E. Meale, Hearing Officer, Division of Administrative Hearings, the DeSoto Bldg., 1230 Apalachee Pkwy, Tallahassee, FL, 32399-1550, and by interoffice delivery to Larry G. McPherson, Jr., Chief Medical Attorney, Department of Business and Professional Regulation, 1940 North Monroe St., Tallahassee, FL 32399-0792 at or before 5:00 p.m., this 13th day of April, 1994.

Docket for Case No: 93-001520

Orders for Case No: 93-001520