Physician

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Now Live: Easier Online License Applications and ​Renewals!

​LicensE is your online, self-guided occupational license application platform. 

Please review the helpful links below:

  • Find step-by-step instruction for license renewal here.
  • Find a list of license renewals available via LicensE in the chart on the LicensE Customer Information page.
  • Find all licenses available via LicensE, plus user guides and other resources, on the LicensE Customer Information page.
  • Anyone applying for an initial license for any of the credentials listed can apply at license.wi.gov.

Our LicensE Application Status Lookup tool makes it easier for employees, and helps academic advisors support students during the license application process. To access the Application Status Lookup tool, you will need the applicant's 10-digit PAR number. An applicant may provide the number to anyone who could support their application. Find more information in our news release about this tool. ​​

​​​​​​​​​​​​​​​Military Medical Personnel Program​

Military Medical Personnel Program participants may temporarily perform certain skilled health services. See Memorandum of Understanding (Form 7158) and Licensure Timeline (Form 7159) for program information.​​

​​License Information

Per Wis. Stat. § 440.08 (2), the required renewal date for the Physician credential is 10/31/ each odd numbered  year.  Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by the statutorily defined date.

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). The UA will benefit physicians by reducing redundancy in filling out multiple applications when applying for licensure in multiple states. Physicians will be able to apply to multiple states by filling out the UA once, then directing it to additional states. 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. Visit the Federation of State Medical Boards website for further information.

In order to prescribe controlled substances, a Physician must obtain a DEA number.  Please contact the DEA for further information on obtaining a DEA number. ​


Pre-Credential Education Information

Graduation from a medical or osteopathic college approved by the board.


Administrative Physician License Information

This license is designed for an applicant whose primary responsibilities are those of an administrative or academic nature.

The holder of an Administrative Physician license may not examine, care for, or treat patients.  An Administrative Physician license does not include the authority to prescribe drugs or controlled substances, delegate medical acts, issue opinions regarding medical necessity or conduct clinical trials on humans.

Applicants for an Administrative Physician license must also meet the same qualifications for licensure as applicants applying under Wis. Stat. § 448.05 (2)(a) or (b).

Visiting Physician License Information

This license is designed for a graduate of a medical school or an osteopathic college that is approved by the Board and who is invited to serve on the academic staff of a medical school in this state as a Visiting Physician.

The holder of a Visiting Physician license may practice medicine and surgery as defined in Wis. Stat. 4​48.01(9), providing such practice is entirely limited to the medical education facility, medical research facility, or the medical college where the license holder is teaching, researching or practicing medicine and surgery and only within the terms and restrictions established by the Board.

A Visiting Physician license is valid for one (1) year from the date of issuance and remains valid only while the holder is actively engaged in teaching, researching or practicing medicine and surgery and is lawfully entitled to work in the United States. The license may be renewed at the discretion of the Board.

FormDescription
570Credentialing Information for Medicine and Surgery Applicants
​3217​Application for Fee Reduction (Optional - If applying for a fee reduction, this form must accompany the application for the credential.)
571Authorization and Waiver
2165Certification of Post-Graduate Training (not necessary if utilizing FCVS)
2164​Medical Education Verification Form (not necessary if utilizing FCVS​)
2167Hospital, Facility and Employer Form (Form is not required for applicants who have only been employed in a strictly training capacity and have not done any moonlighting outside of their training.)
​​ 12829
Physician Malpractice Suits or Claims Form (if applicable)
​3085​Application for Predetermination (Optional-Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal or state law in this state or any other and you desire a review of your conviction record before applying for a credential.)​
2252​Convictions and Pending Charges (if applicable)
3074License Transition Addendum​
3220​Sports Physician Licensure Exemption Extension
​​Application for Camp Physician or Locum Tenens

This license is designed for an applicant who holds a valid license to practice medicine and surgery issued by another licensing jurisdiction of the United States or Canada whose services have been requested by a Physician licensed to practice medicine and surgery in this state or by a Camp Organization or other Recreational Facility of this state.

The holder of a Camp Physician or Locum Tenens license may engage in the practice of medicine and surgery providing such practice is confined to the Camp or Recreational Facility, or geographical area for which the license is issued. The Locum Tenens license allows the applicant to temporarily maintain the practice of another Physician including providing emergency room services normally provided by the other Physician.  A Camp Physician or Locum Tenens license shall expire 90 days from the date of its issuance and may be renewed for additional periods of 90 days each, but no such license may be renewed more than three (3) consecutive times.

Temporary Practice at Camps 

Per Wis. Stat. § 448.033, physicians licensed to practice medicine and surgery in another state or territory of the United States or a Canadian province or territory may practice medicine and surgery to provide treatment to campers and staff for not more than 90 days in any year without holding a license issued under Wis. Stat. ch. 448, Subch​. II. See Form 5568, Out of State Physician Temporary Camp Practice Notification Form, for details. Form 5568 must be submitted prior to practice.

FormDescription
​5568
​Out of State Physician Temporary Camp Practice Notification Form (Form must be submitted prior to practice.)
568Credentialing Information for Locum Tenens or Camp Physician Applicants
​12829
​Physician Malpractice Suits or Claims Form (if applicable)​
2252​Convictions and Pending Charges (if applicable)

Application for Resident Education License (REL)

This license is designed for applicants who have been accepted into a post-graduate training program in a facility in this state approved by the Board under the provisions of Wis. Admin. Cod​e ch.​ Med 5, and accredited by the ​ Accreditation Council for Graduate Medical Education ​(ACGME) or the American Osteopathic Association ​(AOA). The REL is required for the entire duration of your training or until a permanent license to practice medicine and surgery is granted.

The holder of a REL may, under the direction of a person licensed to practice medicine and surgery in this state, perform services requisite to the post-graduate training program in which the licensee is serving. Acting under such direction, the Resident Educational licensee shall also have the right to prescribe drugs and controlled substances, and to sign any certificates, reports or other papers for the use of public authorities which are required of or permitted to persons licensed to practice medicine and surgery.

The Resident Educational licensee shall confine training and entire practice to the post-graduate training program in which the resident educational licensee is taking their training. 

A Resident Educational License to practice medicine and surgery is valid for one (1) year and may be renewed for additional one-year terms as long as the license holder is enrolled in their post-graduate training program.

FormDescription
564Application​ for Resident Educational License 
​2601​Affidavit of Hospital Authority 
3050​​Certificate of Professional Education Form ​
​2329​Verification of Post-Graduate Training REL Renewal Recommendation Form​​
2252Convictions and Pending Charges (if applicable)

Interstate Medical Licensure Compact

FormDescription
2687Authorization for Release of FBI Information
3221​Medical Examining Board Compact Affidavit
3202​Hospital, Facility, and Employer Verification (IMLC)
IMLC​Interstate Medical Licensure Compact​

Renewal Information 

Requirements:

  • FEE (See Renewal Dates and Fees.)
  • SIG (Signature regarding the completion of Continuing Education, included in on-line renewal and paper form. See Continuing Education Information for details.)
  • APP (Form 4570 is required for paper renewal or if instructed to provide due to submitted responses during the online renewal process.)
  • If your legal status as a qualified alien or nonimmigrant lawfully present in the United States has changed since the issuance of your credential or your last renewal, please contact the Wisconsin Department of Safety and Professional Services at 608-266-2112 or dsps@wisconsin.gov.

Renewal Methods:

FormDescription
RDAFRenewal Dates and Fees
​​4570
​Medicine and Surgery Renewal Addendum Form (Required for paper renewal or if instructed to provide due to submitted responses during the online renewal process.)
2254
​Convictions and Pending Charges Form (if applicable for renewal)
R210Active Duty/Discharge Renewal Extension​

2011 Wisconsin Act 210​ (effective June 1, 2012) 

This Act extends the license of a service member if the license expires while they are on active duty from 90 days to 180 days from the date of discharge. The same applies to a spouse of a service member if the spouse does not practice under their license while the service member is on active duty and does not practice because the service member is on active duty.

This Act repeals a provision of prior law that required a service member to meet all of the requirements for license extension or renewal, except for continuing education requirements, in order to have the license extended.

Service members and spouses may request extensions of licenses beyond 180 days from discharge and may request a waiver or extension of time to complete continuing education requirements due to hardship.  Please view Active Duty/Discharge Renewal Extension Form R210 for further information. ​​