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  :  05/23/2007
Application#  :  259624
Name  :  SAIED, NAHEL N
Profession  :  Medicine and Surgery, MD
Address  :  Little Rock, AR
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
Failed 10/26/06 12/21/06
Application Fee Met
Pd. $57.00 for 2nd retake 3/14/07
Pd. $57.00 for retake. Pd. $110.00 7/28/06 $
Pages One and Two - Applicable blanks completed Met
Pre-Professional and Professional Education Met
All activities and practice accounted for Met
See Work History
Pages Three, Four and Five - Applicable blanks completed Met
Affidavit of applicant, signed Met
FLEX scores, original certification Met
Authorization and Waiver, signed (Form #571) Met
Copy of Medical diploma Met
ECFMG certification Met
Physicians Profile Data Report from AOA or AMA Met
Report date 3/7/07
Physician Data Center Practitioner Profile Report (Form #1445) Met
Report date 3/12/07
Work History (Form #1934) Met
Medical Education Verification Form (Form #2164) Met
Graduated 11/87
Will utilize date on certificate
Certificate of Post-Graduate Training (Form #2165) Met
Received Hospital, Facility and Employer Verification Forms Met
Hospital, Facility, and Employer Verification (Form #2167) Met
Verification of state license(s) directly from State Board office(s) Met
Rec'd: IN, MI, MN, MO, OH
National Practitioner Data Bank Report/Self-query response Met
Report date 3/15/07
Social Security Number Met