PDF License Name Case Number Number Reason for Action Type of ... However, it is important to note that any nurse who voluntarily surrenders their license cannot practice nursing or present themselves as a registered nurse or licensed nurse until the Board takes a decision. According to 45 CFR 60.3 [Title 45 -Public Welfare Subtitle a-Department of Health and Human Services Subchapter a-General Administration -Part 60 -National Practitioner-Data Bank for Adverse Information on Physicians and Other Health Care Practitioners-Subpart a- General Provisions . Surrender In the United States, voluntary surrender is when a licensee chooses voluntarily to surrender one's license or voluntarily agrees not to renew one's license, usually to resolve outstanding complaints instead of going through the process of revocation or suspension. (8) Surrender of license. All nurses looking to have their licenses . Nursing Boards' Disciplinary Actions: Learn What's at Stake Voluntary surrender - Wikipedia A licensee of the Texas Medical Board (TMB) has the right to voluntarily surrender his or her medical license. PDF LICENSURE ACTIONS automatic revocations, suspensions or ... revoked in another jurisdiction . PDF Massachusetts Board of Registration In NURSING ... An RN continued to practice nursing for one year after her license expired. Pursuant to Alabama Board of Nursing Administrative Code 610-X-08, Ms. Benson accepted the voluntary surrender for revocation for each of the following nursing licenses. PDF Application for Voluntary Surrender of Premises License Address of Record: 13851 GARVEY AVE Ste C4 . 4/26/19 STRAUBHAAR, LAURIE 33319 RN Voluntary Surrender of License . The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose purpose is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing. Irene Meyers, APRN, license #059078-21/23, Voluntary Surrender of NH APRN license and Voluntary Surrender of Privilege to Practice in NH, effective 12/27/2017. Attorney Bogdan can advise you on how to respond to requests to surrender your DEA registration, and he will work to ensure that you will be able to continue practicing medicine and providing services to patients. Adhere to the terms and conditions of the order. until the nurse receives treatment and obtains one (1) year of sobriety and then probation of the license with a fine and drug stipulations for three (3) years). I hereby waive any and all claims or causes of action that I may have against the State of Ohio, the Ohio Board of Nursing, Board members, officers, employees and/or agents of either, arising out of matters which are the subject of this Initial Voluntary Temporary License/Certificate Surrender. R-882310 on records/Engaged in conduct . The Texas Board of Nursing (BON) accepts the voluntary surrender of the license. Beck, Jennifer Graves Restricted Licensure for a Falsified or made incorrect entries . Hi Lorie. 15 (b) A renewed license shall be issued to a registered professional nurse or licensed Kalyn, Leslie RN53224, APRN001086: Voluntary Surrender of License in Lieu of Other Disciplinary Action for violation of NRS 632.347 (1)(b) by pleading to and being found guilty of an offense related to the qualifications, functions, or duties of a licensee. . 10 voluntary surrender or failure to renew a license, and restoration and reissuance of a license, 11 as follows: 12 "43-26-9. Gamboa, Nicholas, LPN15819: Voluntary Surrender of License in Lieu of Other Disciplinary Action for violation of NRS 632.347 (1)(e) uses any controlled substances, dangerous drugs or intoxicating liquor, (1)(g) unprofessional conduct, (1)(o) failing to comply with a board order, and A nurse who is under investigation for these offenses may voluntarily surrender his/her license to the Board. Renewal of License; Continuing Competency Requirements; Voluntary Surrender; Application for Reinstatement; Temporary Permit Universal Citation: GA Code § 43-26-39 (2020) Licenses issued under this article shall be renewed biennially prior to the expiration of the license according to schedules and fees decided by the board and approved by the . Although Ms. Rotert's deeds are ones that you would never entertain in your practice as a CNA, Nurse Aide or Nurse Assistant, her case and its result have important implications for you. Voluntary Surrender in Lieu of Disciplinary Action for Professions and Occupations Licensed in Nebraska Last 10 years: 11-2011 through 11-2021 Past three months of current year: * The board, in considering her request, cited several violations of the Wyoming Nurse Practice Act due to the LPN's conduct, and if established by "clear and convincing evidence" at a hearing would constitute a violations of . 11/05/12 Consent Order. He resides in Salem, Ore. Rather than incur the legal expenses involved in defending against the complaint in State 1, doctor, nurse, dentist or psychologist moves to State 2, begins practicing there and voluntarily relinquishes his/her license in State 1. Voluntary Surrender: The licensee has surrendered the license as a resolution to a disciplinary matter. Therefore, the following will be proposed to the Oregon State Board of Nursing and is agreed to by Licensee: That the voluntary surrender of the Licensed Practical Nurse license of Debra Casey be accepted. Should I Voluntarily Surrender or Relinquish My Medical License or Nursing License? The facility shall directly notify each patient concerned, the next of kin and/or guardian, the patient's personal physician, and any third party payors concerned at least 30 days prior to the voluntary surrender of the facility's license or surrender of license upon the department's order of revocation, refusal The individual can no longer practice nursing in California. The Board accepted the Voluntary Surrender of Benjamin C. Lawrence's practical nurse license (201607685LPN) for the unauthorized removal of money from the workplace, failure to report his felony arrest to the Board within 10 days, and failing to answer questions truthfully on an application for licensure. Disciplinary action included voluntary surrender of her license, which was recorded as an indefinite suspension. § 21 05-A(l -A)(C). I'm an RN in Texas and I "voluntarily surrendered" my license due to an incident, with the possibility of applying for reinstate after 1 year. they voluntarily surrender the RN license or 2.) Mar 12, 2017. 4668, 5511 . The voluntary surrender invalidates the license at the time of its relinquishment and no person whose license is voluntarily surrendered may practice nursing or represent himself/herself to be a registered nurse or licensed practical . 137117, Penobscot, Maine (Continuing education / License Surrender). Voluntary surrender of license to practice nursing or placing the nursing license on inactive status shall not deprive the board of jurisdiction to proceed with disciplinary proceedings pursuant to chapter 91, HRS, and chapter 16-201.. Has at least one individual who is a representative of consumers on its governing body. Sources: https://www . If the voluntary relinquishment is accepted by the Board of Medicine, then the acceptance of the voluntary relinquishment of the license shall be considered disciplinary action against the license as that term is used in Section 458.331(1)(b), Florida Statutes, and shall be reported as such by the Board of Medicine. The Idaho Board of Nursing recommends license verification via NURSYS - the comprehensive electronic information All applications to the program are confidential. Therefore, the LVN nurse could no longer validly practice nursing in Texas. If you knew you were subject to discipline in state A you were legally obligated to notify state B, by not notifying state B that license is subject to revocation since you . Voluntary Surrender of License Accepted with Conditions In addition, other suspensions of licenses occur in compliance with Statute 59 OS § 567.17I of the Oklahoma Nursing Practice Act, when a nurse defaults on a contract with the Peer Assistance Program a suspension letter is issued, and no Order is entered until the matter is heard by the . Name: WL HOMECARE PHARMACY . In most states, when you voluntarily surrender your nursing or medical license, you also swear to never apply for the reinstatement or make an original application for a new license. Contact our Illinois DEA registration defense attorney at 630-310-1267 to arrange a complimentary consultation. Any nurse who is under investigation for actions outlined above can voluntarily surrender their license to the Board. VOLUNTARY SURRENDER OF LICENSE INSTRUCTIONS: Any licensee wishing to voluntarily surrender his/her Kentucky resident or non-resident license must complete the following form in its entirety, answering completely and correctly, to avoid delays in processing. 13 (a) Licenses issued under this article shall be renewed biennially according to schedules 14 and fees approved by the board. Wynne Brandi J Licensed Practical Nurse LN63985 Voluntary Surrender 06/23/2021 McNary Ashley L Licensed Practical Nurse LN92393 Voluntary Surrender 06/17/2021 Rocha Marie A Registered Nurse RN189570 Reprimand 06/17/2021 White Catherine Licensed Practical Nurse LN44255 Voluntary Surrender 06/09/2021 You agree to never apply again! Writ: A licensee files an appeal in Superior Court asking the court to overturn the Board's disciplinary decision. Therefore, never agree to relinquish your license until you speak with a professional licensing attorney and have had a lot of time to contemplate the decision. A. BROADWAY JD , RN CONSENT AGREEMENT FOR VOLUNTARY SURRENDER INTRODUCTION This document is a Consent Agreement regarding Patricia E. Lanning's ("Licensee") license to practice professional nursing in the State ofMaine. Under TMB rules, a licensee may voluntarily relinquish "his or her license to practice medicine in Texas for any . Your career options can be severely limited by having a surrendered license. The LPN then requested that she voluntarily surrender her license in lieu of proceeding to a contested case hearing. The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose purpose is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing. Such professionals may voluntarily surrender their licenses while receiving treatment rather than face charges of professional misconduct. State regulations differ, so check with your state Board of Nursing (BON) for the particulars in your area. Rather than incur the legal expenses involved in defending against the complaint in State 1, doctor, nurse, dentist or psychologist moves to State 2, begins practicing there and voluntarily relinquishes his/her license in State 1. Allen, Julia Clare Voluntary Surrender Has a license or privilege to . 2 of 3 . Biennial renewal of licenses; continuing competency requirements; voluntary surrender or failure to renew license; restoration and reissuance of license Universal Citation: GA Code § 43-26-9 (2019) (a) Licenses issued under this article shall be renewed biennially according to schedules and fees approved by the board. In accordance with the Nursing Practice Act (NPA), as a nurse, you are allowed to voluntarily surrender your nursing license at any time. Idaho Division of Occupational & Professional Licenses - Board of Nursing - 2 of 3 . Some nurses choose to do so while they're being investigated by the nursing board or awaiting trial on criminal charges.. Minnesota Board of Nursing Report of All Individuals Under Action as of: 11/15/2017 2 Anderson Karin Marie R 985468 Suspended 3/2/2007 Anderson Janice Virginia R 1043529 Voluntary Surrender of Registration Certificate or License 8/3/2000 Licensee's License Date of Name Number Acceptance Patton, Leslie Elizabeth 2-042131 04/22/2021 Remember relinquishing a professional license is forever! LICENSE NUMBER NURSING PRACTICE LAW . Address: Action Taken: Effective Date: Allyson Allen LPN #034239 : Ocala, FL : Voluntary Surrender: 07/27/2021 : Meghan Frederick LPN #037253 Case No. Idaho board of nursing PO Box 83720 Boise, ID 83720-0061 Phone: (208)577-2476 Fax: (208)577-2490 . Alexander Karen Ann L 233958 Voluntary Surrender of Registration Certificate or License 8/5/2010 1 Minnesota Board of Nursing Report of All Individuals Under Action as of: 12/16/2021. R-765343 minimum of (6) months/Legal on records . If a clearance letter is requested, a fee of A complaint is filed with the Department of Health, Professional Board, or other licensing authority in State 1. As part of the disciplinary actions . An today if you have any questions about your response letter or the disciplinary process by calling or texting him at (832) 428-5679 day, night or . The Board may also ask the licensee to participate in an Informal Conference and the Board may take the following actions that the Board considers appropriate: (1) warn, censure, or reprimand; (2) enter into a consent agreement that fixes a period of probation; (3) voluntary surrender of the license and negotiate stipulations for reinstatement . The parties enter into this Agreement pursuant to 10 M.R.S.A. But, when you're being investigated or disciplined, you might also be at one of the . of Portland, Maine 1 VOLUNTARY SURRENDER OF License #PO041 46 1 LICENSE INTRODUCTION This document is a Consent Agreement regarding Dianne L. Waugh's license to practice practical nursing in the State of Maine. Well, one year has passed, and I'm trying to get my license reinstated, but I have no clue what I'm doing and the BON website is very confusing and not . Please note: Our law firm provides legal services for nurses in Oregon, Washington, and Texas. Britto Wendy Licensed Practical Nurse LN59243 Voluntary Surrender 12/18/2017 Johnson Jennifer L Registered Nurse RN283040 Voluntary Surrender 12/15/2017 Langlois Michael J Registered Nurse RN277875 Voluntary Surrender 12/11/2017 Gravel Mary A Registered Nurse RN147389 Suspension 12/08/2017 The Idaho Board of Nursing recommends license verification via NURSYS - the comprehensive electronic information (26) violation of state/federal nursing law/regulation. If, after a minimum of three years, Ms. Casey wishes to reinstate their Licensed Practical Nurse license . Nevada State Board of NURSING A complaint is filed with the Department of Health, Professional Board, or other licensing authority in State 1. NCLEX© quarterly reports, individual program pass rates, and additional information are available on the AZBN website. like Florida (where I currently practice), and the Compact - I am being audited and I realize that I do not have the 30 full credits for the Calif Nursing license requirement - I only have 29.8 - am short by 0.8 credits. NO12441800 NJ00098900 Weissman, Lois A.P.N., R.N. If you voluntarily agreed to surrender your nursing license due to allegations or proof of unprofessional conduct, getting it back can be a long and winding road. While surrendering your nursing license might seem like a good idea at the time, (when you're in the middle of a crisis), we urge you to give us a call before you make such an enormous, life . Voluntary surrender is often viewed as a proactive action and is considered to be more amiable than having the sanction of . Once a RN license is surrendered or revoked, it is possible to get it back but it is a long process and it is an up-hill battle. R-871363 practice as a nurse suspended or . 4/26/19 STRAUBHAAR, LAURIE 33319 RN Voluntary Surrender of License . Reinstatement of license after voluntary surrender? As a nurse, you can voluntarily surrender your nursing license at any time. :2021-000343 Action Date: 08/05/2021 Reason for Action: On August 5, 2021, the Board of Nursing adopted a Voluntary Surrender of Jane Stewart's practical nurse license, No. When you surrender your nursing license (or are merely faced with the issue when you are accused of wrongdoing), you will likely be reasonably concerned. 82 (c) The voluntary surrender of a license or the failure to renew a license by the end of an 83 established renewal period shall have the same effect as revocation of said license, subject 84 to reinstatement at the discretion of the board. The terms of discipline, if any, can include a suspension of license and privileges . A nurse is offered a voluntary surrender to settle the allegations against the nurse at the BON (or maybe the nurse is suspended or revoked, losing his/her license). Name License No. Should I Voluntarily Surrender or Relinquish My Medical License or Nursing License? Denial of Licensure, Suspension, Revocation, or Voluntary Surrender. (26) violation of state/federal nursing law/regulation. Action: Voluntary Surrender of license to practice nursing, same as revocation. APPLICATION FOR VOLUNTARY SURRENDER OF PREMISES LICENSE . •Nurse submitted certificates for 2 of the 4 ordered CE courses immediately upon the suspension of his license. Voluntary Surrender of License Law and Legal Definition. surrender of, suspended, placed on probation, refused to renew a professional license, certificate or multi-state privilege held by you now or previously, or ever fined, censured, reprimanded or otherwise disciplined you? Denial of Licensure, Revocation or Voluntary Surrender when omission or violation is associated with high risk of patient injury or death. Baldwin PARK, CA 91706 . Voluntary Surrender of License Accepted with Conditions Burton, Connie Yevette Bolden, RN/lpn R0093093 No Further Action. Belle, Valencia Andrea Revocation Falsified or made incorrect entries . 5 8003(5)(B), (5)!C)(3)and 32 M.R.S.A. Remember relinquishing a professional license is forever! In most states, when you voluntarily surrender your nursing or medical license, you also swear to never apply for the reinstatement or make an original application for a new license. Well, one year has passed, and I'm trying to get my license reinstated, but I have no clue what I'm doing and the BON website is very confusing and not . Therefore, never agree to relinquish your license until you speak with a professional licensing attorney and have had a lot of time to contemplate the decision. The nurse agrees to the surrender because the BON tells the nurse that he/she can request the license back after one year and that the nurse either give up the license or have it . Pursuant to the terms and conditions of probation against my premises license with the California State Board A three-member panel of the Committee for Professional Assistance interviews applicants for admission to PAP and considers petitions for license restoration. For information about the voluntary surrender of a nursing license, or to schedule a free consultation with an attorney, call (503) 232-9280, or e-mail contact@nursesattorney.com. Stipulation of facts: Kitts was accused in August 2020 of diverting narcotics for his own use while employed at . Voluntary surrender of license, registration, or certification.3-1205.18.. Can I voluntarily surrender my California Nursing RN license - will that affect my other licenses with other states,? Board Action: April 2017 Voluntary Surrender Brooke Muhlenkort-Spring TX License R040370 Description: Substance Abuse Disorder Board Action: February 2017 Voluntary Surrender Cassandra J Van Berkum-Rock Rapids IA License IA LPN P50359 Description: Diversion Board Action: February 2017 Voluntary Surrender of Privilege to Practice Jody Moore-Ewing VA New Jersey Board of Nursing Disciplinary and Licensure / Certification Actions December 2012 Schlembach, Andrea A.P.N, R.N. If you surrender your nursing license then you will not be able to practice for a certain period of time, but may be able to apply for reinstatement at a later date. -Failed to submit documentation of the remaining 2 CE courses within 12 months -Failed to pay the fine within 12 months •Nursing License was REVOKED after 12 months elapsed •What needs to be done to apply for reinstatement . Denial of Licensure, Suspension, Revocation, or Voluntary Surrender. in an Enforced Suspension until the nurse receives treatment and obtains one (1) year of sobriety and then probation of the license with a fine and drug stipulations for three (3) years). License #R030825 STATE OF MAINE BOARD OF NURSING STATE HOUSE STATION AUGUSTA, MAINE 04333-0158 R.N. NURSE Lic. On May 6, 2021, the Alaska Board of Nursing adopted a voluntary surrender for Vicie Zielinski, Registered Nurse License Number NURR27008. Allen, Rachel M. Voluntary Surrender Violated a rule or regulation . the RN license is revoked by the BRN. 11/02/12 Consent Order for Voluntary Surrender of License. The Board of Nursing accepted the voluntary surrender of the CNA's certificate. Monica Denham, RN, license #064444-21, Voluntary Surrender of License, effective 12/26/2017. Adhere to the terms and conditions of . Voluntary Surrender of License: A type of Consent Order in which the license or permit is invalidated at the time of relinquishment; the findings of fact are admitted; the individual is ineligible for license reinstatement for a minimum of two years and until meeting certain requirements; and the action is reported in the same manner as a final . AMY BRITT Profession: LICENSED PRACTICAL . PLEASE PRINT IN BLACK OR BLUE INK OR TYPE YOUR RESPONSES . Consult with Texas nurse attorney Yong J. Admave Shannon Marie L 594309 Voluntary Surrender of Registration Certificate or License 12/6/2012 . Arkansas State Board of Nursing DISCIPLINARY ACTIONS November 2020 NAME LICENSE NUMBER(S) CITY ACTION VIOLATION DATE Aycock Joseph Parker R051237 Little Rock Voluntary Surrender (a)(9) 11/17/2020 Ayers VOLUNTARY SURRENDER: Accept a voluntary surrender of a license certificate. SUSPENSION: The period of suspension prevents the licensee from working as a practical (LPN) or professional (RN) nurse for definite or indefinite period of time. LICENSE NUMBER NURSING PRACTICE LAW . Licensed Practical Nurse license. If you are being investigated by the Texas Board of Nursing - or even if you're in the disciplinary phase - this might seem like the easiest thing to do, at the time. The following is a list of all Nursing Assistant, Practical Nursing and Registered Nursing programs that have been Revoked, Suspended or have Voluntarily Surrendered their program. Registered nurses will lose their RN licenses for 2 reasons: 1.) Voluntary Surrender Consent Order Page 2 WHEREAS, Licensee has agreed that she would surrender her South Dakota nursing licenses; and WHEREAS, the South Dakota Board of Nursing ("the Board") has a statutory obligation to protect the public health, safety and welfare set forth in SDCL §36­9, You are aware that voluntary surrender is like an admission of guilt and state A will send the information regarding being reported to the BoN to state B. Reinstatement of license after voluntary surrender? License to Practice as a Registered Nurse to Remain on Probation with the Terms and Conditions of the Previous Order to Remain in Full Force and Effect - "Restricted" Campbell, Jeanne Renee Boyer, RN Arkansas State Board of Nursing DISCIPLINARY ACTIONS October 2021 NAME LICENSE NUMBER(S) CITY ACTION VIOLATION DATE (9/10 - 10/14/21) Allen Angela Daniele Shealy Myers L052318 North Little Rock Suspension - 2 years (a)(6) 10/13/2021 Boyd I'm an RN in Texas and I "voluntarily surrendered" my license due to an incident, with the possibility of applying for reinstate after 1 year. (You may exclude disciplinary actions taken by or disclosed to the Texas Board of Nursing on an initial licensure Voluntary Surrender of License in Lieu of Other Disciplinary Action for violation of NRS 632.347 (1)(e) controlled substances and/or alcohol, (1)(g) unprofessional conduct, (1)(o) failing to comply with a Board order and NAC 632.890 (36) failing to comply. 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