State of Minnesota Payments to Practitioners Reporting Form - 2007
Wholesaler/Manufacturer Name UCB, Inc. and Schwarz Pharma Manufacturing
Wholesaler/Manufacturer 1950 Lake Park Drive
Address Smyrna, GA 30080
Minnesota License Number 360006-07 (UCB, Inc.), 459706 (Schwarz Pharma Manufacturing)
Name of Individual Completing Report Sherry Jackson
Phone number 770-970-2992
Background information and instructions: Minnesota Statutes require wholesale drug distributors and manufacturers to file with the Board of Pharmacy an annual report identifying certain payments made
to practitioners. (Practitioners are those licensed health professsionals who are authorized to prescribe drugs. Pharmacists are not practitioners). The payments that must be reported include: honoraria and
payments for expenses of a practitioner who serves as a speaker at a professional or educational conference or meeting; and compensation for substantial professional or consulting services of a practitioner
working on a genuine research project. (See Minnesota Statutes 151.461 and 151.47). The report must identify the specific reason for payments totalling $100 or more. In the column marked "Specific reason
for payment", please list the reason for the payment. (e.g. "honoraria and expenses for speaking", "payment for research consultation", etc.). Do not list general reasons (e.g. "payments for consultation",
"payments for services rendered"). Reports filed under this provision are public data. Reports must be filed in an electronic format, so please fill out this spreadsheet and return it to the Board either attached to
an e-mail (Pharmacy.Board@state.mn.us) or copied onto a CD_ROM.
LAST NAME OF FIRST NAME OF Professional ADDRESS OF PRACTITIONER PAYMENT INFORMATION
PRACTITIONER PRACTITIONER designation Street Address City State Zip Code Value of Specific reason for payment
(e.g. MD), if any Payment
Albrecht Linda MD 3960 Coon Rapid Blvd Coon Rapids MN 55433 $ 118.22 Out of Pocket Expense for Non-Ed Program
Blum Paul MD 3955 Parklawn Avenue Edina MN 55435 $ 1,000.00 Speaker Fee
Blum Paul MD 3955 Parklawn Avenue Edina MN 55435 $ 1,000.00 Honoraria
Bushara Khalafalla MD 6431 Pinnacle Drive Eden Prairie MN 55346 $ 500.00 Honorarium for Speaker Training
Cascino Gregory MD 200 First Street SW Rochester MN 55905 $ 1,500.00 Honorarium Speaker Program
Cascino Gregory MD 200 First Street SW Rochester MN 55905 $ 1,500.00 Honorarium Speaker Program
Cascino Gregory MD 200 First Street SW Rochester MN 55905 $ 131.00 Out of Pocket Expense for Speaker
Program
Cascino Gregory MD 200 First Street SW Rochester MN 55905 $ 72.11 Out of Pocket Expense for Speaker
Program
Cascino Gregory MD 200 First Street SW Rochester MN 55905 $ 1,500.00 Honorarium Speaker Program
Devalk Marcia NP 919 Lafond Ave St. Paul MN 55104 $ 1,539.70 Breakfast Program
Doescher Jason MD 310 North Smith Ave Suite 300 St. Paul MN 55102 $ 1,500.00 Speaker Fee
Doescher Jason MD 310 North Smith Ave Suite 300 St. Paul MN 55102 $ 750.00 Honorarium Advocate Program
Doescher Jason MD 310 North Smith Ave Suite 300 St. Paul MN 55102 $ 1,500.00 Honorarium Speaker Program
Doescher Jason MD 310 North Smith Ave Suite 300 St. Paul MN 55102 $ 750.00 Honorarium Speaker Program
Doescher Jason MD 310 North Smith Ave Suite 300 St. Paul MN 55102 $ 1,500.00 Honorarium Speaker Program
Doescher Jason MD 310 North Smith Ave Suite 300 St. Paul MN 55102 $ 1,500.00 Honorarium Speaker Program
Ellingson Amy MD 330 West Center Ave Clara City MN 56222 $ 1,121.25 Honorarium/Exp
Ellingson Amy MD 330 West Center Ave Clara City MN 56222 $ 1,500.00 Honorarium
Ellingson AMY MD 330 West Center Ave Clara City MN 56222 $ 1,000.00 Honorarium Speaker Program
Exconde Rupert MD One Veteran's Drive Minneapolis MN 55417 $ 1,500.00 Honorarium Speaker Program
Exconde Rupert MD One Veteran's Drive Minneapolis MN 55417 $ 42.55 Out of Pocket Expense for Speaker
Program
LAST NAME OF FIRST NAME OF Professional ADDRESS OF PRACTITIONER PAYMENT INFORMATION
PRACTITIONER PRACTITIONER designation Street Address City State Zip Code Value of Specific reason for payment
(e.g. MD), if any Payment
Gustafson Mary NP 345 SMITH AVE N Saint Paul MN 55102 $ 2,050.00 IIS Fee
Gustafson Mary NP 345 SMITH AVE N Saint Paul MN 55102 $ 1,500.00 Honorarium Speaker Program
Gustafson Mary NP 345 SMITH AVE N Saint Paul MN 55102 $ 1,200.00 Honorarium Speaker Program
Gustafson Mary NP 345 SMITH AVE N Saint Paul MN 55102 $ 1,200.00 Honorarium Speaker Program
Gustafson Mary NP 345 SMITH AVE N Saint Paul MN 55102 $ 1,200.00 Honorarium Speaker Program
Gustafson Mary NP 345 SMITH AVE N Saint Paul MN 55102 $ 2,050.00 RETROSPECTIVE ANALYSIS
Harris Pamela MD 3800 Park Nicollet Blvd Minneapolis MN $ 1,000.00 Honoraria
Jarmuskewicz James MD 1526 30th St NW Bemidj MN 56601 $ 1,000.00 Speaker Fee
Jarmuskewicz James MD 1526 30th St NW Bemidj MN 56601 $ 1,072.75 Honorarium/Exp
Kane Sunanda MD 200 First Street, S.W. Rochester MN 55905 $ 3,200.00 Honorarium for MSL Ad Board
Kane Sunanda MD 200 First Street, S.W. Rochester MN 55905 $ 992.00 Out of Pocket Expense for MSL Ad Board
Kelkar Pramod MD 12000 Elm Creek Blvd Suite 200 Maple Grove MN 55369 $ 1,000.00 Speaker Fee
Kelkar Pramod MD 8675 Valley Creek Rd Woodberry MN 55125 $ 1,000.00 Speaker Fee
Kelkar Pramod MD 12000 Elm Creek Blvd N Maple Grove MN 55369 $ 1,019.40 Honorarium/Exp
Kelkar Pramod MD 12000 Elm Creek Blvd N Maple Grove MN 55369 $ 1,024.25 Honorarium/Exp
Kelkar Pramod MD 12000 Elm Creek Blvd N Maple Grove MN 55369 $ 1,283.95 Honorarium/Exp
Leppik Ilo MD 5775 Wayzata Blvd St Louis Park MN 55416 $ 542.36 Expense Reimbursement
Leppik Ilo MD 5775 Wayzata Blvd St Louis Park MN 55416 $ 542.36 Expense Reimbursement
Leppik Ilo MD 5775 Wayzata Blvd St Louis Park MN 55416 $ 2,000.00 Honorarium for Registry Panel
Leppik Ilo MD Regents of the University of Minneapolis MN 55455-2070 $ 19,817.70 Investigator Initiated Study Payments
Minnesota, Office of Sponsored
Financial Reporting , 200 Oak
Street, SE, Suite 450
Leppik Ilo MD Regents of the University of Minneapolis MN 55455-2070 $ 46,241.30 Investigator Initiated Study Payments
Minnesota, Office of Sponsored
Financial Reporting , 200 Oak
Street, SE, Suite 450
Leppik Ilo MD Regents of the University of Minneapolis MN 55455-2070 $ 66,059.00 Investigator Initiated Study Payments
Minnesota, Office of Sponsored
Financial Reporting , 200 Oak
Street, SE, Suite 450
Leppik Ilo MD 5775 Wayzata Blvd St Louis Park MN 55416 $ 2,000.00 Honorarium for Speaker Program
Loftus Edward MD 200 First Street, S.W. Rochester MN 55905 $ 74.69 Out of Pocket Expense for Non-Ed Program
Loftus Edward MD 200 First Street, S.W. Rochester MN 55905 $ 2,000.00 Honorarium for Non-Ed Program
Loftus, Jr. Edward MD 200 First Street, S.W. Rochester MN 55905 $ 3,200.00 Honorarium for MSL Ad Board
Loftus, Jr. Edward MD 200 First Street, S.W. Rochester MN 55905 $ 1,004.00 Honorarium for MSL Ad Board
Lowe David MD 210 9th Street SE Rochester MN 55904 $ 1,650.00 Honoraria
Mehta Hemalini MD 1149 Medical Arts Bldg Minneapolis MN 55441 $ 1,004.85 Honorarium/Exp
Mehta Hemalini MD 825 Nicollet Mali #1149 Minneapolis MN 55402 $ 1,000.00 Speaker Fee
LAST NAME OF FIRST NAME OF Professional ADDRESS OF PRACTITIONER PAYMENT INFORMATION
PRACTITIONER PRACTITIONER designation Street Address City State Zip Code Value of Specific reason for payment
(e.g. MD), if any Payment
Moriarity, Jr. Gerald MD 344 Salem Church Rd Minneapolis MN 55455 $ 1,500.00 Honorarium for Speaker Program
Patterson Edward St. Paul $ 918.58 EXPENSE REIMBURSEMENT TO
TRAVEL TO AES IN DEC
Payne Troy MD 2025 Stearns Way St Cloud MN $ 1,000.00 Lecture Honorarium
Penovich Patricia MD 310 Smith Ave N. Ste 300 St Paul MN 55102 $ 1,500.00 Speaker Fee
Penovich Patricia MD 310 Smith Ave N. Ste 300 St Paul MN 55102 $ 1,500.00 Honorarium for Speaker Program
Reaney Judson MD 11455 Viking Dr Eden Prairie MN 55344 $ 1,014.55 Lunch Program
Reaney Judson MD 11455 Viking Dr Eden Prairie MN 55344 $ 1,024.25 Honorarium/Exp
Reaney Judson MD 11455 Viking Dr Eden Prairie MN 55344 $ 1,000.00 Speaker Fee
Reaney Judson MD 11455 Viking Dr Eden Prairie MN 55344 $ 1,000.00 Speaker Fee
Ritter Frank MD 310 No Smith Avenue St. Paul MN 55102 $ 9,500.00 Full Study Payment
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 9,500.00 Investigator Initiated Study Payments
Ritter Frank MD 310 No Smith Avenue St. Paul MN 55102 $ 1,500.00 Speaker Fee
Ritter Frank MD 310 No Smith Avenue St. Paul MN 55102 $ 1,500.00 Speaker Fee
Ritter Frank MD 310 No Smith Avenue St. Paul MN 55102 $ 1,500.00 Speaker Fee
Ritter Frank MD 310 No Smith Avenue St. Paul MN 55102 $ 1,500.00 Speaker Fee
Ritter Frank MD 310 No Smith Avenue St. Paul MN 55102 $ 1,500.00 Speaker Fee
Ritter Frank MD 310 No Smith Avenue St. Paul MN 55102 $ 1,500.00 Speaker Fee
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 1,500.00 Honorarium for Speaker Program
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 1,500.00 Honorarium for Speaker Program
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 1,500.00 Honorarium for Speaker Program
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 88.19 Out of Pocket Expense for Speaker
Program
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 31.08 Out of Pocket Expense for Speaker
Program
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 23.08 Out of Pocket Expense for Speaker
Program
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 1,500.00 Honorarium for Speaker Program
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 1,500.00 Honorarium for Speaker Program
Ritter Frank MD 1690 Neal Avenue, North Stillwater MN 55082 $ 1,500.00 Honorarium for Speaker Program
Rogin Joanne MD 4225 Golden Valley Road Golden Valley MN 55422 $ 1,500.00 Honorarium for Speaker Program
Rogin Joanne MD 4225 Golden Valley Road Golden Valley MN 55422 $ 68.00 Out of Pocket Expense for Speaker
Program
Sandborn William MD 200 1st St SW Rochester MN 55905 $ 161.89 Participated in Type A Meeting
Sandborn William MD 200 1st St SW Rochester MN 55905 $ 1,005.88 Reimbursement Expense
Stillerman Allan MD 825 Nicollet Mall Minneapolis MN 55402 $ 1,009.70 Honorarium/Exp
Stillerman Allan MD 825 Nicollet Mall Minneapolis MN 55402 $ 1,000.00 Speaker Fee
Swihart Ernest Jr. MD 17705 Hutchins Dr Minnetonka MN 55345 $ 1,009.70 Honorarium
Swihart Ernest Jr. MD 17705 Hutchins Dr Minnetonka MN 55345 $ 1,760.00 Honorarium/Exp
Weinberg David MD 15700 37th Ave. N Plymouth MN 55414 $ 2,000.00 Honorarium for MSL Ad Board
Weinberg David MD 15700 37th Ave. N Plymouth MN 55414 $ 1,021.00 Honorarium for MSL Ad Board