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  :  06/13/2018
Application#  :  642231
Name  :  Fagbemi, Olufisayo
Profession  :  Resident Educational License
Address  :  GREENFIELD, WI
Application Status  :  (Temporary permit 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)
Application Fee Met
$30
Application Complete Met
Certification of Legal Status Completed Met
Electronic affidavit via OLAS Met
Certificate of Professional Education Form #3050 Met
JR
Affidavit of Hospital Authority Form #2601 Met
starts 7/1/18
-jt
Social Security Number Met