(1) Actions subject to reporting Each Board of Medical Examiners
(A) which revokes or suspends (or otherwise restricts) a physicians license or censures, reprimands, or places on probation a physician, for reasons relating to the physicians professional competence or professional conduct, or
(B) to which a physicians license is surrendered,
shall report, in accordance with section 11134 of this title, the information described in paragraph (2).
(2) Information to be reported The information to be reported under paragraph (1) is
(A) the name of the physician involved,
(B) a description of the acts or omissions or other reasons (if known) for the revocation, suspension, or surrender of license, and
(C) such other information respecting the circumstances of the action or surrender as the Secretary deems appropriate.