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
:
01/10/2022
Application#
:
784914
Name
:
Kurbel, Hunter M
Profession
:
Registered Nurse
Address
:
Madison, 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
11/22/21: Reviewed. --- EOY
Application Fee
Met
11/22/21: Received. --- EOY $72
Primary State of Residence
Met
11/22/21: Reviewed. --- EOY
PAGE 2 List all professional and non professional activities and list every state that you have ever held a license in.
Met
11/22/21: Reviewed. --- EOY
PAGE 3 and 4 All questions answered and relevant copies attached.
Met
11/22/21: Reviewed. --- EOY
Certification of Legal Status Completed
Met
11/22/21: Reviewed. --- EOY
PAGE 5 Affidavit of applicant signed.
Met
11/22/21: Reviewed. --- EOY
Social Security Number
Met
11/22/21: Reviewed. --- EOY
Statement of Graduation from your school
Met
11/22/21: 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. -EOY
Eligible to Take NCLEX
Met
11/22/21: 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. --- EOY
Authorization for release of FBI information (#2687)
Met
1/4/22: rec'd - MG
11/22/21: 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 upload it to your OLAS account or email it to DSPSCREDNursing@wi.gov. If emailing, 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.
--- EOY
Electronic Document Uploaded on 12/28/2021 10:25:16 PM; Electronic Document Uploaded on 12/28/2021 10:39:05 PM; Electronic Document Uploaded on 12/28/2021 10:39:20 PM;
FBI Fingerprint
Met
1/10/22: Reviewed. --- EOY
1/4/22:emailed instructions - MG
NCLEX results
Met
OTHER
Met
1/10/22: Reviewed. --- EOY
11/22/21: Your application has been reviewed. This item will remain unmet until all other requirements are met. --- EOY
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