The holder of an Administrative Physician license may not examine, care for, or treat patients. This license is designed for an applicant whose primary responsibilities are those of an administrative or academic nature. Note: Please see Form #570 for additional documents that are required along with an online application.Īdministrative Physician License Information OLAS (Online Licensure Application System) may be used to apply online. Graduation from a medical or osteopathic college approved by the board.Īpplication for Endorsement by Exam, Administrative Physician and Visiting Physician Please contact theĭEA for further information on obtaining a DEA number. In order to prescribe controlled substances, a Physician must obtain a DEA number. Visit theįederation of State Medical Boards' website for further information. Once completed, the UA can be imported to your state of Wisconsin license application, leaving only the state-specific instructions and addendums of the application to be completed. Physicians will be able to apply to multiple states by filling out the UA once, then directing it to additional states. The UA will benefit physicians by reducing redundancy in filling out multiple applications when applying for licensure in multiple states. The State of Wisconsin Medical Examining Board is pleased to offer the new online application process for medical and osteopathic physicians called the Uniform Application for Physician State Licensure (UA). Months leading up to this date, you are still required to renew your license by Should you receive your initial credential in the
§ 440.08 (2), the required renewal date for the To determine eligibility please visit the United States Department of Health and Human Services website at, prior to submitting Form 3217. Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services.
Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee. Pursuant toġ11.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page. To apply for a predetermination, please fill outįorm #3085 and submit all required documentation specified on the form. 2017 Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record.
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