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  :  05/06/2022
Application#  :  784905
Name  :  Johnson, Jenna M
Profession  :  Registered Nurse
Address  :  Merrimac, 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)
PAGE1 Applicable Blanks completed Met
Application Fee Met
11/26/21: $72.00 exam application fee needed ($57 ICF/$15 contract exam). If you have not already submitted fees separately from the application, please print a copy of this page and return with $72.00 payment to DSPS, PO BOX 8935, MADISON WI 53708-8935 OR you may fax credit card payment using the Fax Payment Form available at https://dsps.wi.gov/Credentialing/General/fm3071.pdf - KG $72
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
PAGE 3 and 4 All questions answered and relevant copies attached. Met
Certification of Legal Status Completed Met
PAGE 5 Affidavit of applicant signed. Met
Social Security Number Met
Statement of Graduation from your school Met
11/26/21: Received form #3049, certificate of approval to take examination early. Statement of graduation from your school will still need to be received before license can be issued. ------ KG
Eligible to Take NCLEX Met
1/14/22: You have been made eligible to test for NCLEX. You will receive scheduling information from the testing company within a few days via the email address you provided to the testing company. If the first and last name on your ATT does not match the ID you will be using at the testing site, please email corrections to DSPSCredNursing@wi.gov. Middle names and addresses do not need to match. – KG
Authorization for release of FBI information (#2687) Met
3/22/22: received ---RG
1/14/22: Received form #2687. However, applicant’s photograph was not submitted with form #2687. Please email a photograph of yourself (head and shoulders only) to dspscrednursing@wisconsin.gov. Please include your name, profession and application ID number when sending to our department. After we receive and process it, you will be emailed the fingerprint information. --KG
11/26/21: You answered yes to the multi-state license. Therefore, please complete and submit the Authorization for Release of FBI Information (Form #2687) available here: https://dsps.wi.gov/Credentialing/Health/fm2687.pdf, along with a photograph of yourself (head and shoulders only) and email it to dspscrednursing@wisconsin.gov. Please include your name, profession and application ID number when sending to our department. After we receive and process it, you will be emailed the fingerprint information. --KGElectronic Document Uploaded on 12/17/2021 1:41:55 PM;
FBI Fingerprint Met
5/6/22: Rec'd--NT
3/22/22: instructions emailed to applicant ---RG
NCLEX results Met