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
:
09/06/2023
Application#
:
803614
Name
:
Piorkowski, Katie M
Profession
:
Registered Nurse
Address
:
Greendale, 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
5/6/22: Your application has been reviewed. This item will remain unmet until all other requirements are met. --NT
Application Fee
Met
$140
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
Eligible to Take NCLEX
Met
5/9/23: Rec’d form #1055 & fee. 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 Raymond.Greco@wisconsin.gov Middle names and addresses do not need to match. - RG
10/24/22: NCLEX results have been emailed to email address on file; To apply for retake, you need to obtain, complete & submit form #1055 available on our website at https://dsps.wi.gov/Credentialing/Health/fm1055.pdf We cannot make you eligible to test until this form has been received with the $15.00 retake fee & you have re-registered with PearsonVue. --NT
9/29/22: Rec’d form #1055 & fee. 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@wisconsin.gov. Middle names and addresses do not need to match. – NT
8/19/22: NCLEX results have been emailed to email address on file; To apply for retake, you need to obtain, complete & submit form #1055 available on our website at https://dsps.wi.gov/Credentialing/Health/fm1055.pdf We cannot make you eligible to test until this form has been received with the $15.00 retake fee & you have re-registered with PearsonVue. --NT
07/13/2022: Rec’d form #1055 & fee. 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 ad
Information on Conviction(s)/Pending Charge(s) (Form # 2254)
Met
9.6.2023 Report/Docs reviewed. Ordinance violation over 7 years. No further CIB legal review needed, approved per delegated authority. ST
6/14/22: You answered YES to the question(s) regarding convictions and/or pending charges. Please complete Form #2254 and payment. Payment can be submitted using Form #3071. You may email this document directly to DSPSCredCIB@wisconsin.gov, or fax to 608-251-3036 or mail to: "DSPS, P.O. Box 8935, Madison, WI 53708, Attention: CIB." BE SURE TO INCLUDE YOUR APPLICATION NUMBER WITH ANY AND ALL INFORMATION SENT TO US. Thank you. - MG
NCLEX results
Met
Passed--NT
OTHER
Met
Rec'd Marriage Certificate--NT
6/15/23: You have applied with the name ‘Katie Piorkowski’ but your Support Ticket information shows the name ‘Katie Hayes’ Please email photocopy of legal state issued document showing proof of legal name as you are recognized by the US Government to DSPSCredNursing@wi.gov --KG
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