1. (1) An applicant for licensure under this chapter shall file with the board a completed application on a form provided by the board. The application shall include:

   1. (a) The signature of the applicant.
   2. (b) Notice as to whether the applicant has been disciplined in any state in which he or she has held a license.
   3. (c) The fees authorized in s. 440.05 (1), Stats.
   4. (d) A certified transcript of the coursework completed by the applicant submitted directly to the board from a program accredited by the Accreditation Council on Optometric Education.

   5. (e) Verification of the applicant’s licensure submitted directly to the board by all states in which the applicant has ever held a license.

      Note: Application forms are available on the department’s website at https.//dsps.wi.gov, or by request from the Department of Safety and Professional Services, P.O. Box 8935, Madison, Wisconsin 53708, or call (608) 266-2112. An otherwise qualified applicant with a disability shall be provided with reasonable accommodations.

2. (2) Applicants who have a pending criminal charge or have been convicted of any crime shall provide the board all related information necessary for the board to determine whether the circumstances of the pending criminal charge or conviction are substantially related to the circumstances of the licensed activity, subject to ss. 111.321, 111.322, and 111.335, Stats.
3. (3) An application may not be considered by the board until the application is complete, including the requisite application materials under sub. (1), verification of examination scores from the National Board of Examiners in Optometry in accordance with s. Opt 4.03, or any other required information under this chapter.

History

History: Cr. Register, March, 1989, No. 399, eff. 4-1-89; am. (1) (intro.) and (c), Register, June, 1990, No. 414, eff. 7-1-90; am. (1) (c), Register, July, 1994, No. 463, eff. 8-1-94; am. (1) (c), Register, April, 1996, No. 484, eff. 5-1-96; am. (1), renum. (2), (3) and (4) to be (1) (d), (e) and (2) and am. (1) (d) and (e), Register, September, 1997, No. 501, eff. 10-1-97; CR 06-116: am. (1) (intro.) and (c) Register May 2007 No. 617, eff. 6-1-07; CR 19-026: r. and recr. (1) (d), am. (2), cr. (3) Register January 2020 No. 769, eff. 2-1-20.