A Falmouth psychiatrist can no longer practice medicine in Maine after he signed a consent agreement that permanently revokes his license, the Maine state medical board announced on Tuesday.

Dr. Reinaldo de los Heros, who operated a practice in Portland, had his license suspended Oct. 10 by the Maine Board of Licensure in Medicine for falsifying records and other reasons. De los Heros signed an agreement Oct. 23 with the licensing board, and it was finalized on Tuesday. The agreement says that the board concluded there was evidence of de los Heros committing “fraud, deceit or misrepresentation.”

“Previously, on October 10, 2017, the Board issued an Order of Immediate Suspension of Dr. de los Heros’ medical license based upon a finding that he issued a prescription for a controlled substance for a patient he knew was incarcerated and created a medical record indicating that there was an in-person 25-minute office visit regarding the incarcerated patient. At that time, the Board concluded that Dr. de los Heros’s continued ability to practice medicine, including prescribing controlled substances, represented an immediate jeopardy to the public,” according to a statement issued Tuesday.

A permanent license revocation by the Maine medical board is extremely rare. The last time was in 2011, when it permanently revoked the license of a former Brunswick psychiatrist, Dr. John M. Dorn, for having inappropriate romantic relationships with patients and for failing to disclose previous sexual relationships with patients in other states when he applied for a Maine license in 2007.

The licensing board typically imposes 25 to 30 licensing sanctions on medical doctors each year, according to the board’s website, which lists 24 “adverse licensing actions” so far in 2017. Most of the disciplinary actions are less stringent than license revocation, and typically involve a temporary license suspension, practice restrictions, requirements for counseling and supervision by a peer, and occasional fines.

De los Heros prescribed Adderall, which is used to control attention-deficit disorder, to a patient who was in the Cumberland County Jail. The doctor had been operating under supervision since 2016 and has a record of disciplinary actions in Maine and Massachusetts dating back to the 1990s.

In February 2016, the board placed de los Heros on probation for the way he practiced medicine leading up to the drug overdose of one of his patients. Kelly Deyo, 39, took her life on April 19, 2015, and 19 mostly empty prescription pill bottles and a suicide note were found by her side at her apartment in Westbrook. The bottles, including refills, had contained pills from nine prescriptions written by de los Heros. Deyo had struggled with heroin addiction and many mental health problems, her mother, Elizabeth Marquis, told the Press Herald.

The 2016 licensing board sanctions were for failing to coordinate Deyo’s care with her primary care physicians and poor documentation of her visits, including incomplete or illegible treatment notes, according to the agreement.

In April 2017, the licensing board and de los Heros agreed to an amendment to his license. The amendment required the doctor to allow the state to select 10 patient records for the board’s review.

The Massachusetts licensing board punished de los Heros in the 1990s and 2000s for Medicaid fraud, and for fraudulently trying to regain his medical license.

His license to practice in Massachusetts was revoked in 1997 for Medicaid billing fraud, according to Massachusetts medical board records. He failed to disclose his disciplinary history on forms in Massachusetts when trying to regain his license in 2007, the records show, including that his license was revoked in other states, that he had a 2006 consent agreement in Maine with the state licensing board, and that his medical malpractice insurance company had imposed a surcharge on his policy.

In 2009, de los Heros signed a consent agreement with the Maine board that required him to practice under the supervision of another psychiatrist.

The Maine licensing board consists of six physicians, three members of the public and a physician assistant. All 10 are appointed by the governor.