Larry, you are right, but until the LAW says the patient is the end user, there will be little compliance. I remember a while back when hip implants were failing, and the lawyers were advertising on TV for a class action suit. How many patients know who made their $100,000 hip implant, let alone their $1500 crown?
The solution is THIS in my opinion:
1) Only Credentialed technicians may own and operate a lab
2) Dentists should not be exempt from FDA import rules
3) Enforce FDA registration and GMP's
4) Lab FDA number in patient record
5) Material disclosure to patient as the end user
State registration is an unfair burden on small labs, and is a "pay to play" penalty for labs who do mail order work. One FEDERAL regstration should be enough.