Five plastic surgeons, a nurse, and their office manager each pleaded guilty to misdemeanor charges in federal court in Albany, New York, on Tuesday after admitting they ordered and used an unapproved Botox-like drug to treat more than 150 patients in 2004.

US Magistrate Judge David R. Homer accepted guilty pleas to misdemeanor drug misbranding charges from Albany-area doctors William F. DeLuca Jr., Douglas M. Hargrave, Steven M. Lynch, John D. Noonan and Jeffrey L. Rockmore, all of The Plastic Surgery Group of Albany.

Their guilty pleas in US District Court took place three hours after an attorney for The Plastic Surgery Group, which is located on Washington Avenue and is one of the region’s largest plastic surgery practices, entered a guilty plea to a related felony charge on behalf of their practice.

The case stems from a years-long criminal investigation by the U.S. Food and Drug Administration of an Arizona company that distributed thousands of doses of a Botox-like drug to physicians across the country.