# Interstate Medical Licensure Compact: 2026 Workflow & How Assured Automates It ## Introduction Expanding medical practice across state lines has never been easier—at least in theory. The Interstate Medical Licensure Compact (IMLC) provides a solution to this. The agreement offers a process for physicians to obtain licenses in multiple states, making it an attractive option for those in telemedicine, multi-state practices, or mobile healthcare services. However, IMLC isn’t always a one-size-fits-all solution. It comes with costs, eligibility restrictions, and limitations that can make the traditional licensing process a better choice. This guide breaks down everything you need to know: - What IMLC is - When it provides a clear return on investment (ROI) - And when traditional licensing is the smarter move ## What is IMLC? The [Interstate Medical Licensure Compact (IMLC)](https://imlcc.com/) is an agreement between participating U.S. states that allows qualified physicians to obtain licenses in multiple states through a streamlined process. Instead of applying separately to each state’s medical board, eligible physicians can apply for a single expedited process, significantly reducing administrative burden and approval times. ### List of Interstate Medical Licensure Compact (IMLC) Participating States: 01. Alabama 02. Arizona 03. Arkansas 04. Colorado 05. Connecticut 06. Delaware 07. District of Columbia 08. Georgia 09. Guam 10. Idaho 11. Illinois 12. Indiana 13. Iowa 14. Kansas 15. Kentucky 16. Louisiana 17. Maine 18. Maryland 19. Michigan 20. Minnesota 21. Mississippi 22. Missouri 23. Montana 24. Nebraska 25. Nevada 26. New Hampshire 27. New Jersey 28. North Dakota 29. Ohio 30. Oklahoma 31. Pennsylvania 32. South Dakota 33. Tennessee 34. Texas 35. Utah 36. Vermont 37. Washington 38. West Virginia 39. Wisconsin 40. Wyoming 41. Florida 42. Hawaii - _States issuing licenses but not serving as States of Principal Licensure (SPL):_ Connecticut, Pennsylvania, Vermont - _States with legislation passed but implementation pending or delayed:_ Arkansas, Massachusetts, New Mexico, New York, Rhode Island Note that 42 states, the District of Columbia, and Guam are part of the compact. Some states can issue licenses through the IMLC but cannot serve as an SPL for entry into the compact. Others have introduced or passed legislation to join but are not yet fully operational. ### IMLC Core Eligibility Requirements Not all physicians qualify for the IMLC. To be eligible, you must meet these criteria: - Hold a full, unrestricted medical license in a Compact member state eligible to serve as a State of Principal License (SPL) - The SPL must be the physician’s primary residence, or at least 25% of their medical practice must occur there - Physicians can qualify if employed by an organization based in the SPL - The SPL must be used as the physician’s state of residence for U.S. federal income tax purposes - SPL status must be maintained at all times, but it can be updated after receiving a letter of qualification - Must have graduated from an accredited medical school or one listed in the International Medical Education Directory - Must have completed an [ACGME or AOA-accredited graduate medical education program](https://www.acgme.org/programs-and-institutions/) - Must have passed the [United States Medical Licensing Examination (USMLE)](https://www.usmle.org/), [Comprehensive Osteopathic Medical Licensing Examination of the United States **(COMLEX-USA)](https://en.wikipedia.org/wiki/COMLEX-USA), or an accepted predecessor exam within three attempts per component (LMCC is not accepted) - Must hold a current or time-unlimited specialty certification from an [American Board of Medical Specialties (ABMS)](https://www.abms.org/) or [American Osteopathic Board of Orthopedic Surgery (AOABOS)](https://en.wikipedia.org/wiki/American_Osteopathic_Board_of_Orthopedic_Surgery) - Must have no history of disciplinary actions against their medical license - Must have no criminal history - Must have no history of controlled substance-related actions against their medical license - Must not be under investigation at the time of application ## The Complete 10-Step IMLC Workflow Process Here's the definitive step-by-step process for obtaining licenses through IMLC: 1. **Eligibility Verification and Documentation Gathering** - **Timeline:** 1-2 weeks - Verify you meet all IMLC eligibility requirements - Confirm your State of Principal License (SPL) qualifies - Gather required documents: medical school diploma, board certification, background check results 2. **State of Principal License (SPL) Selection and Validation** - **Timeline:** 2-3 days - Confirm SPL meets residency or practice percentage requirements (25% minimum) - Validate SPL status for federal tax purposes - Ensure SPL can serve as primary license for IMLC entry 3. **Primary Source Verification Initiation** - **Timeline:** 1-2 weeks - Request verification from medical school - Obtain board certification verification - Secure residency program confirmation - Order background checks and fingerprinting 4. **IMLC Application Submission** - **Timeline:** 1-2 days - Complete IMLC online application - Upload all required documentation - Pay IMLC application fee ($700) - Submit to SPL medical board 5. **SPL Review and Letter of Qualification (LOQ) Processing** - **Timeline:** 2-4 weeks - SPL medical board reviews application - Board verifies credentials and eligibility - LOQ issued if approved, or rejection notice if denied 6. **Target State Selection and Fee Planning** - **Timeline:** 1-2 days - Select states where you need licenses - Calculate total licensing fees - Plan application priority based on processing times 7. **Multi-State License Applications** - **Timeline:** 1 week - Submit license applications to selected states - Pay individual state fees - Upload state-specific requirements - Provide additional documentation if requested 8. **State Board Reviews and Follow-ups** - **Timeline:** 2-8 weeks per state - Monitor application status across all states - Respond to additional document requests - Provide clarifications if needed - Track processing timelines 9. **License Issuance and Activation** - **Timeline:** 1-2 days per state - Receive license approval notifications - Download official license documents - Verify license details for accuracy - Activate licenses for practice 10. **Renewal Setup and Ongoing Compliance** - **Timeline:** Ongoing - Set up renewal reminders for each state - Track continuing education requirements - Monitor compliance deadlines - Plan for future license additions ## Concluding Thoughts The Interstate Medical Licensure Compact (IMLC) offers a faster, more streamlined way for physicians to secure multiple state licenses. However, it’s not a one-size-fits-all solution. Before deciding, carefully evaluate your practice needs, long-term goals, and financial considerations. If speed and multi-state access are priorities, IMLC may be the right fit. If simplicity matters more, traditional licensing could be the smarter move.