The North Dakota State Board of Pharmacy has taken action against three out-of-state pharmacies for illegally selling tramadol via Internet sites to North Dakota residents, as reported by The Jamestown Sun. The three pharmacies – located in Hawaii, Pennsylvania, and New Jersey – sold tramadol to North Dakota residents without requiring valid prescriptions based on a valid patient-physician relationship. The three pharmacies also failed to comply with North Dakota prescription monitoring program reporting requirements. Two of the pharmacies are not licensed in North Dakota. Howard Anderson, executive director, North Dakota State Board of Pharmacy told The Jamestown Sun that the pharmacies have agreed to stop dispensing drugs to North Dakota residents and that stipulations are pending, but that they are subject to fines. The Jamestown Sun also reports that the North Dakota State Board of Medical Examiners is investigating out-of-state physicians who have prescribed tramadol to residents over the Internet and without a North Dakota medical license.