DEVALL. PATRICK
        GOVERNOR

  TIMOTHY P. MURRAY
LIEUTENANT GOVERNOR

  JUDYANN  BIGBY, MD
         SECRETARY

   JOHN AUERBACH
    COMMISSIONER

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

Board of Registration in Pharmacy
239 Causeway Street, Suite 500, 5th Floor 
Boston, MA 02114
(800) 414-0168 I fax 617-973-0983/ TTY 617-973-0895
http://www.mass.gov/dph/boards/pharmacy

          February 17, 2012

          James R. Henschke

Re:		Voluntary Surrender Statement dated February 10, 2012 
 Pharmacy Intern registration No. 154882
 Complaint Docket No. PH-2012-0018 
Dear Mr. Henschke:

The Board of Registration in Pharmacy (Board) bas accepted the Voluntary Surrender Statement you executed (February 10, 20 12) in resolution of the above-referenced complaint regarding your Massachusetts Pharmacy Intern Registration No. 154882.

Very Truly Yours, 

Michael J. Tocco, R.Ph., M.Ed.
President

cc: Patrick Mulvey, Esq.
Mulvey Professional Association
378 Islington Street
Portsmouth, NH 03801

	

COMMONWEALTH OF MASSACHUSETTS

SUFFOLK COUNTY					BOARD OF REGISTRATION
							IN PHARMACY

In the Matter of 
James R. Henschke					Docket No. PHA-2012-0018
Reg. No. 154882 (exp. 10/20/2013)

VOLUNTARY SURRENDER STATEMENT

1.	I, James R. Henschke (Reg. No. 154882), 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 on the Board:
2.	I acknowledge and agree that I have surrendered my license to the Board in resolution of Complaint Docket No. PHA-2012-0018 (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 10th day of 
February 2012.

James R. Henschke