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  :  05/03/2017
Application#  :  604891
Name  :  LIFE TREE PHARMACY LLC
Profession  :  Pharmacy (in state)
Address  :  MILWAUKEE, 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)
Type of License Met
Application Fee Met
$85
Applicant address of facility Met
Mailing address until day of opening Met
Proposed Opening date Met
Owner Partners Corporate Officers, titles, etc Met
Pharmacy Hours Daily Saturday Sunday Met
Barrier Requested? Met
4/12/2017: Barrier question on Page 1 of application – please indicate if appropriate barrier will be used per Wis Admin Code Phar 6.04(3)(1). You may send your response by email to: DSPSCredPharmacy@WI.gov. Please refer to your application ID number in your correspondence. Thank you.
Managing Pharmacist Affidavit and License # Met
Inspection Ready Date (self inspection will be used) Met
Affidavit of applicant, signed. Met
Floor plan - original (scaled to size, location of sink and refrigerator with prescription counter space clearly indicated) Met
Federal Identification Number Collection Met
Self Inspection Report Met
4/12/17: ON SELF INSPECTION REPORT, PAGE 1 OF 17, QUESTIONS 1-24 NEED TO BE DATED, NOT CHECK MARKED.

THE SELF INSPECTION PAGES 2-17 WERE DONE INCORRECTLY. PLEASE RE-READ INSTRUCTIONS ON PAGE 2, & RESUBMIT THESE PAGES. NUMBERS MUST BE DATED, AND ALL QUESTIONS THAT WERE MARKED WITH N/A, NEED TO BE LISTED ON PAGE 17 AS TO WHY THOSE RULES DIDN'T APPLY TO YOUR FACILITY. PLEASE SUBMIT THIS INFORMATION TO: DSPSCREDPHARMACY@WI.GOV OR FAX TO: 608-261-7083 IF YOU WOULD LIKE FUTURE CORRESPONDANCE BY EMAIL, PLEASE SEND AN EMAIL TO WHERE YOU WOULD LIKE THAT SENT TO AND WE WILL PUT THIS INTO OUR SYSTEM. ALSO INCLUDE YOUR APPLICATION ID # WHEN SUBMITTING INFORMATION TO US.