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  :  01/13/2014
Application#  :  481556
Name  :  PATIN, LATOYA D
Profession  :  Registered Nurse
Address  :  BATON ROUGE, LA
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)
PAGE1 Applicable Blanks completed Met
Application Fee Met
$82
Primary State of Residence Met
PAGE 2 List all professional and non professional activities and list every state that you have ever held a license in. Met
Verification of state license(s) and/or credential(s) Met
1/13/14: Rec'd: CA;
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9/17/13: NEED: CA; If you have not already done so, please download and send our form 741 (available at http://dsps.wi.gov) to CA for them to complete and submit directly to our department by mail. Please check with that state for their mailing address and if you need to include a fee for their verification. Once received in our agency, please allow 15-20 business days for processing.
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9/17/13: Received GA;
LA, MN, MI (active) thru NURSYS;
PAGE 3 and 4 All questions answered and relevant copies attached. Met
12/19/13: rec'd;
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Communicable disease form (#1229) needed. You can obtain the form by using the following link: http://165.189.64.111/Documents/Credentialing%20Forms/Health%20Application%20Forms/Information%20Required%20by%20HFS%20145%20on%20Communicable%20Diseases%20fm1229.pdf Be sure to put your name, profession and ID number on top of page prior to mailing.
Certification of Legal Status Completed Met
PAGE 5 Affidavit of applicant signed. Met
Social Security Number Met
Statement of Graduation from your school Met
10-14-13 update: received/processed SOG -----

9/17/13: Received form 259, however, form 259 was not filled out correctly/completely. Please send form 259 (available from dsps.wi.gov), back to the school, the school must complete and send directly to us (we need the box checked on form 259 whether the school was state approved at the time you graduated), OR the school can email this information directly to DSPSCREDNursing@wi.gov Also, we do not accept any online degree verifications