Physician Assistant

​​​​Additional Resources

Other Forms

Statutes and Administrative Code

Exam Information

Offenses that May Result in Refusal, Bar, or Termination of Licensure

Related Links

Physician Assistant Affiliated Credentialing Board​

Orders and Disciplinary Actions

Conviction Self Report

Professional Assistance Procedure

Monitoring

File a Complaint

Wisconsin Emergency Assistance Volunteer Registry (WEAVR)

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​​​ ​​​​Now Live: Easier Online License Applications!

LicensE, our new, online, self-guided occupational license application platform is now live! The list of licenses available via LicensE is available HERE​.  Starting on May 16, 2022, those applicants can apply at license.wi.gov.​

LicensE is for new, initial applications only. To renew your license, click HERE. You should not use LicensE to renew your license at this time.​


For additional information, please see the LicensE User Guides and Video page. ​Check back for updates, FAQs, and application tips.

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ALERT: 2021 ​​​​​Wisconsin Act 23​ became effective April 1, 2022. Select the "Statutes and Administrative Code" link to the left to view Wis. Stat. ch. 448 and related administrative code.​​

​License Information

Per Wisconsin State Statutes 440.08 (2), the required renewal date for the Physician Assistant credential is 02/28 or 29/even years.  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.


Pre-Credential Education Information

Graduate from an approved educational program for physician assistants. The Physician Assistant Affiliated Credentialing Board only approves educational programs accredited and approved by the committee on allied health education and accreditation of the American Medical Association.  The Physician Assistant Affiliated Credentialing Board only approves accredited educational programs and recognizes accreditation by the following agencies: American Medical Association (AMA), AMA Council on Medical Education, Committee on Allied Education and Accreditation (CAHEA), Commission on Accreditation of Allied Health Education Programs (CAAHEP).


Application for Licensure (including for a license expired 5 or more years)

FormDescription
580Credentialing Information Physician Assistant Applicants​

​3217​Application for Fee Reduction (If applying for a fee reduction, this form must accompany Form #580.)
1504Physician Assistant Certificate of Professional Education (this must come directly from the school)
2829Malpractice 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
3071​Fax Payment Form
​2147​Physician Requirements and Guidelines
2450​​The Amphetamine Rule
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Renewal Information 

Requirements

  • FEE (See Renewal Dates and Fees)
  • 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
R210Active Duty/Discharge Renewal Extension
​2254​
​Convictions and Pending Charges, if applicable

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.