The Commonwealth of Massachusetts 
Executive Office of Health and Human Services Department of Public Health
Division of Health Professions Licensure

DEVALL PATRICK
GOVERNOR

TIMOTHY P. MURRAY
LIEUTENANTGOVERNOR

JUDYANN BIGBY, MD
SECRETARY

JOHN AUERBACH
COMMISSIONER

Board of Registration in Pharmacy
239 Causeway Street, Suite 500, 5th Floor 
Boston, MA 02114
       (800) 414-0168
http://www.mass.gov/dph/boards/pharmacy

September 5, 2012	First Class Mail and Certified Mail 7010 2780 0001 8675 8633

           Daniel E. Kaeka

Re:  Voluntary Surrender Statement dated August 28, 2012- Docket No. PHA-2012-0173  
        Pharmacy Intern Registration No.158310 - Acceptance of Registration Surrender

Dear Daniel E. Kaeka

The Board of Registration in Pharmacy (Board) is in receipt of the Voluntary Surrender Statement dated August 28, 2012 (Surrender Statement) you executed in resolution of above­ referenced Complaint Docket No. PHA-2012-0173 (Complaint).

Please be advised that, in accordance with Board regulation 247 CMR 10.06(6), the Board has accepted the Surrender Staten1ent in resolution of the Complaint on the terms and conditions set forth therein that the registration surrender is voluntarily tendered; that registration surrender is considered to be a reportable disciplinary action depriving you of all privileges of registration; that the Surrender Statement is a public document subject to disclosure by the Board; that registration surrender is not subject to reconsideration  or judicial review; and that the Board will not review any application for registration as a pharmacy intern in the future.

You have stated to Board Investigator Cheryl Lathum that you are not in possession of your wallet registration card which may have been lost during the event which resulted in the pending court proceedings.

The Board will close the Complaint as a "Voluntary Surrender" on this date. Please contact Executive Director James D. Coffey (617) 973 0950 with any questions.

Very truly yours,

James T. DeVita, R. Ph., President
Board Decision No. 2977

COMMONWEALTH OF MASSACHUSETTS

SUFFOLK COUNTY						BOARD OF REGISTRATION 
						IN PHARMACY

In the Matter of 
Daniel K. Kaeka						Docket No. PHA-2012-0173
Reg. No. 158310 (exp. 04/02/2017)

VOLUNTARY SURRENDER STATEMENT

I, Daniel K. Kaeka (Reg. No. 158310), do voluntarily surrender my license to practice as a pharmacy intern in the Commonwealth of Massachusetts to the Board of Registration in Pharmacy (Board) and do state to the Board:

1.	I hereby voluntarily surrender my license to practice as a pharmacy intern in the Commonwealth of Massachusetts (Reg. No. 158310) together with any right to renew my license, to the Board, effective as of the date of my signature hereto:
2.	I acknowledge and agree that I have surrendered my license to the Board in resolution of Complaint Docket No. PHA-2012-0173 (Complaint);
3.	I understand that surrender of my license is considered to be a reportable disciplinary act which deprives me of all privileges of registration, that my surrender is not subject to reconsideration or judicial review; and that I am waiving my right to a hearing pursuant to G.L. c. 30A regarding the Complaint;
4.	I will surrender any current license or registration to practice as a pharmacy intern issued by any other jurisdiction effective as of the date of my signature hereto and will not apply or attempt to gain licensure as a pharmacy intern or to renew any pharmacy intern license previously issued by any other jurisdiction; and
5.	I acknowledge that I have been provided the opportunity to consult legal counsel regarding my decision to execute this statement and surrender my license and that my decision to execute this statement and surrender my license was made of my own free will.

SIGNED UNDER THE PAINS AND PENALTIES OF PERJURY this 28th day of August 2012.  

Daniel K. Kaeka