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Dr. Gustavo Jose Carvalho has been in trouble with legal and regulatory authorities for serious improprieties almost from the time he was licensed to practice medicine in B.C. in 1990.

Now, after an audit found fake patient appointments and billing errors of about $200,000, he has the distinction of being the first doctor in B.C. permanently struck from the Medical Services Commission against his will, according to the Ministry of Health. (A few other doctors voluntarily dropped out after damning audits.)

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Carvalho, who got his medical degree in 1988 from the University of Alberta, and has worked at a Richmond walk-in clinic in the Ackroyd Medical Centre since 1990. It is unclear where, or if, he will work now.

Susan Prins, spokeswoman for the College of Physicians and Surgeons, said it recently learned of the Commission’s decision. The College, which licenses doctors, is now required to conduct its own investigation which could lead to disciplinary action. She couldn’t say if he might lose his licence to practise in B.C.