Voluntary Surrender Agreement Sample Contracts

AMENDMENT
Voluntary Surrender Agreement • March 29th, 2001 • K Tel International Inc • Phonograph records & prerecorded audio tapes & disks
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RECITALS:
Voluntary Surrender Agreement • December 7th, 2009 • Amish Naturals, Inc. • Miscellaneous food preparations & kindred products • Ohio
VOLUNTARY SURRENDER AGREEMENT
Voluntary Surrender Agreement • November 3rd, 2020

The Board of Registration in Pharmacy ("Board") and Joseph C. Ward, R.Ph. ("Registrant"), a pharmacist registered by the Board (Pharmacist Registration No. 15980) do hereby stipulate and agree that the following information shall be entered into and become a permanent part of the file of the Registrant which is maintained by the Board:

VOLUNTARY SURRENDER AGREEMENT
Voluntary Surrender Agreement • November 6th, 2020

The Board of Registration in Pharmacy (Board) and Michael D. Bendell, R.Ph. (Registrant), a pharmacist registered by the Board (Pharmacist Registration No. 21078), do hereby stipulate and agree that the following information shall be entered into and become a permanent part of the file of the Registrant which is maintained by the Board:

VOLUNTARY SURRENDER AGREEMENT
Voluntary Surrender Agreement • September 4th, 2009 • Nature Vision, Inc. • Photographic equipment & supplies • Minnesota

NOW, THEREFORE, in consideration of the foregoing, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows:

SUFFOLK COUNTY BOARD OF REGISTRATION OF PHYSICIAN ASSISTANTS In the Matter of Joseph J. Bartoszek, Jr., PA-C Docket No. PA-2011-001 License No. PA1347 (License Expiration Date 3/1/13) VOLUNTARY SURRENDER AGREEMENT
Voluntary Surrender Agreement • March 8th, 2022

The Board of Registration of Physician Assistants ("Board") and Joseph J. Bartoszek, Jr. (“Licensee”), a Physician Assistant licensed by the Board, License No. PA1347, do hereby stipulate and agree to enter into this Voluntary Surrender Agreement ("Agreement") in resolution of a complaint identified as Docket No. PA-2011-001 (“Complaint”). The complaint is based on the Licensee's disclosure on his 2011 license renewal application that his Connecticut Physician Assistant license had been disciplined in 2011 and on the information obtained by the Board during the Complaint investigation.

COMMONWEALTH OF MASSACHUSETTS
Voluntary Surrender Agreement • September 17th, 2020

The Massachusetts Board of Registration in Pharmacy ("Board") and registered pharmacist Robert Audet ("Registrant"), Registration No. PH 13088, do hereby stipulate and agree that the following .information shall be entered into and become a permanent part of the Registrant's record as maintained by the Board:

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