(1) An applicant who holds certification in
clinical perfusion granted by the American Board of Cardiovascular Perfusion
may apply to the board for a temporary locum tenens license.
An applicant for a locum tenens license
shall submit all of the following:
completed application on a form provided by the board.
(b) A letter from a physician licensed to
practice medicine and surgery in this state or a perfusionist licensed to
practice perfusion in this state requesting the applicant's services.
(c) Verified evidence of certification in
clinical perfusion granted by the American Board of Cardiovascular
(d) A verified statement
by the applicant that the applicant is familiar with the health laws of this
state and rules of the department of health services related to communicable
(e) The fees required
shall pass the examination under s.
(4) The holder of a locum tenens license may
engage in the practice of perfusion only in the geographical area for which the
license is issued.
(5) A locum
tenens license expires 90 days from the date of its issuance. For cause shown
to the satisfaction of the board, the board may renew the locum tenens license
for additional periods of 90 days each, but a license may not be renewed more
than 3 consecutive times.
Wis. Admin. Code Medical Examining Board § Med 22.06
CR 03-023: cr. Register
March 2004 No. 579, eff. 4-1-04; correction in (2) (d), (e) made under s.
(b) 6, Stats., Register November 2011 No.
Amended by, CR
18-074: am. (1), (2) (intro.), (a), (d), (e), (3), (5)
July 2019 No. 763, eff. 8/1/2019