Wisconsin Department of Safety and Professional Services
Health & Business Renewal Application
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
:
01/15/2014
Application#
:
478322
Name
:
Jabian, Felpur E
Profession
:
Physical Therapist
Address
:
Sunrise, FL
Application Status
:
Withdrawn (Abandoned)
Requirements Not Met:
Description
Status
Comments (Please note, not all requirements will include comments)
Wisconsin Statutes & Rules Examination
Not Met
Link to statutes:
http://dsps.wi.gov/Documents/Board%20Services/Codebooks/203D%20POD%20Physical%20Therapy%20and%20Physical%20Therapist%20Assistants-Book%20OCTOBER%202012.pdf
Before you start the exam review the instructions at: http://dsps.wi.gov/Default.aspx?Page=e0c2691d-b253-4760-9442-dd57f495d5be
Open book exam is on our website at: http://eptol.drl.wi.gov/
Passing score is 85%.
Choose from the drop down menu: Test Launching.
When you're at the ParTest Online you will need the following info:
Instructor: gsp
Test Name: PTA13A
Test Password: PTA13A
Student ID: 478322
Applicable blanks completed
Not Met
1/15/14: When all application requirements are met, application will be sent to the board liaisons for review.
Offical Score Report from TOEFL
Not Met
1/15/14: Rec'd request for waiver. Request will be forwarded along with application to board liaisons when all other application requirements are met.
Requirements Met:
Description
Status
Comments (Please note, not all requirements will include comments)
Application Fee
Met
$150
PAGE 2 All activities & practice accounted for from date of graduation to present. Provide employers name, location (city&state), dates (month&year), # of hours worked per week, job title & duties
Met
Verification of other state license(s) and/or credential(s)
Met
Rec'd: IL, IN, Philippines
PAGE 2, 3 & 4 All questions answered and relevant copies attached
Met
PAGE 4 Affidavit of applicant, signed and notarized
Met
PAGE 5 Social Security Number
Met
Certificate of Professional Education (Form #3196)
Met
NPTE score transfer results received from FSBPT
Met
30 hours of continuing education
Met
1/15/14: Rec'd CE.
8/1/2013: Submit proof of completion of at least 30 hours of continuing education approved by the board within 2 years prior to application (Wis. Admin Code ยง PT 9). Four (4) of the required 30 hours must be in the area of ethics and jurisprudence. You may send proof of completion directly by email to: brittany.grunewald@wisconsin.gov; by mail to: DSPS, ATTN:PHYSICAL THERAPY EXAMING BOARD, P.O. BOX 8935 MADISON, WI 53708-8935; or by fax to: 608-261-7083. Please allow 7-10 business days for processing once received by the department.
Certification of Legal Status Completed
Met
Evaluation completed from foreign graduate evaluation service
Met
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