Application Status Query

Instructions: 

Please allow one hour after receipt of your status update email for the updates to be reflected in the online checklist.

Please verify the checklist information below, including your address. If your address has changed, please e-mail your application number, name, profession, along with your old and new address. The Credentialing department posts status information following receipt and review of application materials.

As of  :  10/06/2009
Application#  :  323354
Name  :  McKenna, Patrick A
Profession  :  Medicine and Surgery, MD
Address  :  Antigo, WI
Application Status  :  (Permanent license issued)


Requirements Not Met:
Description Status Comments (Please note, not all requirements will include comments)

Requirements Met:
Description Status Comments (Please note, not all requirements will include comments)
WI Statute & Rules Examination Met
PASSED
Social Security Number Met
Application Fee Met
Pd 10/29/08 $
Pages One and Two - Applicable blanks completed Met
Pre-Professional and Professional Education Met
All activities and practice accounted for Met
Pages Three, Four and Five - Applicable blanks completed Met
Affidavit of applicant, signed Met
USMLE Step 1, Step 2 scores Met
USMLE Step 3 score (after exam) Met
PASSED
USMLE application received Met
USMLE application mailed to FSMB Met
Authorization and Waiver, signed (Form #571) Met
Copy of Medical diploma Met
Certification of Legal Status Completed Met
Medical Education Verification Form (Form #2164) Met
Graduated 5/08
Certificate of Post-Graduate Training (Form #2165) Need after passing Step 3. Met
National Practitioner Data Bank Report/Self-query Met
Report date 9/14/09