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What Physicians need to know about the Interstate Medical Licensure Compact

A 2022 survey, the U.S. Census Bureau Household Pulse Survey, found that 1 in 5 Americans are currently utilizing telehealth. 

Even though telemedicine is becoming increasingly popular, it wasn’t until recently that doctors and medical specialists could offer their expertise across state lines. That changed in 2014 with the creation of the Interstate Medical Licensure Compact (IMLC), a collaboration that now includes 29 states, the District of Columbia, and Guam

If you reside in and hold a medical license in one of the participating states, you can expand your practice, your patient base, and your bottom line. However, before you begin, it’s important to understand all aspects of the IMLC in order to avoid potential penalties or fines. 

What is the IMLC?

A group of state medical board executives, attorneys, and administrators drafted the IMLC in early 2013. Originally, the goal of the compact was to expedite the licensing process for experienced physicians, allowing them to offer their services in more than one state.

In addition, the IMLC promotes access for rural and underserved communities to important health care services through the promotion of telehealth technologies, including smartphones, web cameras, and videoconferencing.

The compact lays out licensing guidelines and outlines a process for medical professionals to receive a medical license in states where they don’t already practice. This allows doctors to expand the reach of their practices, while assisting patients they might not be able to see otherwise. 


Can any physician participate in the IMLC?

To participate in the IMLC, you must already reside in a state that’s a member of the compact. In addition, you’re required to pay a $700 non-refundable application fee and must submit your fingerprints to a criminal justice agency selected by the State of Principal License (ie: the state where you currently practice and hold a full, unrestricted medical license). This allows the criminal background and screening process to begin. 


Once I apply to the IMLC, am I automatically guaranteed entrance?

Not necessarily. To achieve membership in the compact, you also must prove that you do, in fact, practice medicine in your state of principal license. There are four routes you can take to do this:


  1. Submit paperwork that proves you’re a permanent resident in the state where you practice.
  2. Submit paperwork that proves at least 25 percent of your current practice load takes place in your state of residence.
  3. Submit tax returns that prove you pay both federal and state income tax in your state of residence.
  4. Submit paperwork that proves your primary employer has a location (ie: hospital or clinic) in your state of residence.


Once you prove your state of principal license, the IMLC can approve medical licensure in another compact participating state. 

What is an IMLC Letter of Qualification?

A Letter of Qualification allows you to request expedited medical licensing in any IMLC member state. Once you receive your Letter of Qualification, you have 365 days to apply for one or more additional licenses via the IMLC website.


Can I apply for more than one medical license at a time?

Yes. The IMLC allows you to apply for multiple medical licenses. However, you can only receive licensing in states that have already adopted the compact and incorporated it into state law. To access a map of IMLC member states, click here. 

Each state you apply for has its own licensing fees. You’re also required to pay an additional $100 for each state you hope to receive licensing in. After filling out all the necessary paperwork and submitting your fees, the IMLC notifies each state you’re eligible for licensing. 


Is there anything else I should know about the IMLC?

Every year, more states join the compact, but the IMLC doesn’t apply to the entire nation. As a medical professional, it’s your job to understand the rules and regulations of each state you practice in. This means complying with all statutes, laws, and guidelines, while maintaining an active medical license in each state where you provide medical care.

If you’d like to stay abreast of changes, such as the entrance of new member states, or legislation impacting the IMLC, sign up for the compact’s “interested parties” list. To submit your contact information, send an email request to imlccexecutivedirector@imlcc.net


The IMLC presents an opportunity for you to expand your medical practice and client base. It also encourages the use of telemedicine, which is ideal in today’s current medical climate. However, it’s crucial you adhere to all of the rules laid out by the compact and renew your license accordingly. To learn more about the benefits of joining, and whether or not you qualify, visit the IMLC website here.


What Physicians need to know about the Interstate Medical Licensure Compact
Chad Birt

Chad Birt is a freelance B2B and B2C medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.