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  :  NONE
Application#  :  111605
Name  :  Wu, Xiaowen
Profession  :  Medicine and Surgery, MD
Address  :  Norcross, GA
Application Status  :  Withdrawn (Abandoned)


Requirements Not Met:
Description Status Comments (Please note, not all requirements will include comments)
WI Statute & Rules Examination Not Met
Is name on all credentials the same? If not, submit copy of marriage certificate, divorce decree, etc. Not Met
Application Fee Not Met
Pages One and Two - Applicable blanks completed Not Met
Pre-Professional and Professional Education Not Met
All activities and practice accounted for Not Met
Pages Three, Four and Five - Applicable blanks completed Not Met
All questions answered and relevant copies attached Not Met
Affidavit of applicant, signed Not Met
FLEX scores, original certification Not Met
National Board Scores, original certification Not Met
USMLE (Step 1, Step 2, Step 3) Not Met
LMCC Certification, directly from the Medical Council of Canada Not Met
Certificate of Board issuing original license Not Met
Authorization and Waiver, signed (Form #571) Not Met
Copy of Medical diploma Not Met
ECFMG certification Not Met
Copies of court allegations/dismissal and/or insurance documents of all malpractice suit(s) Not Met
Physicians Profile Data Report from AOA or AMA Not Met
Physician Data Center Practitioner Profile Report (Form #1445) Not Met
Work History (Form #1934) Not Met
Medical Education Verification Form (Form #2164) Not Met
Certificate of Post-Graduate Training (Form #2165) Not Met
Received Hospital, Facility and Employer Verification Forms Not Met
Hospital, Facility, and Employer Verification (Form #2167) Not Met
Verification of state license(s) directly from State Board office(s) Not Met
National Practitioner Data Bank Report/Self-query response Not Met
Social Security Number Not Met
USMLE ID Not Met
Oral Exam Not Met

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