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
:
10/15/2021
Application#
:
773667
Name
:
Barnett, Taylor L
Profession
:
Medicine and Surgery, MD
Address
:
San Antonio, TX
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)
Application Fee
Met
$60
Application Complete
Met
All activities and practice accounted for
Met
Certification of Legal Status Completed
Met
Electronic affidavit via OLAS
Met
Authorization and Waiver, signed (Form #571)
Met
USMLE (Step 1, Step 2, Step 3)
Met
Rec'd. kjc
Physicians Profile Data Report from AOA or AMA
Met
Report Date 7/20/21 ALM
Physician Data Center Practitioner Profile Report (Form #1445)
Met
Report Date: 7/28/2021
-dd
Medical Education Verification Form (Form #2164)
Met
University of Tennessee 5/31/2013
Certificate of Post-Graduate Training (Form #2165)
Met
Need:Scripps Clinic6/25/2013 - 6/30/2016
Rec'd:San Antonio 8/1/2016 - 7/31/2019
Hospital, Facility, and Employer Verification (Form #2167)
Met
Brooke Army 8/2019 - 7/2021
Verification of state license(s) directly from State Board office(s)
Met
NE CA
National Practitioner Data Bank Report/Self-query response
Met
Oral Exam to be determined after application is completed
Met
Social Security Number
Met
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