Every 6 months or upon request of the board, the holder of a provisional license under s. 448.04 (1) (br) shall submit to the board a statement certifying whether the license holder is still employed as a physician in this state and whether the license holder has been subjected to professional discipline as a result of the license holder's practice. If the license holder has been subject to professional discipline, the license holder shall submit to the board a description of the circumstances of the discipline.
Wis. Stat. § 448.075