Interstate Medical Licensure Compact (IMLC) 2025: State List, Eligibility, and Benefits

The healthcare landscape in the United States is rapidly changing, with an increasing demand for qualified medical professionals, particularly in underserved areas. To meet this demand, many physicians are exploring opportunities to expand their practice across state lines. This is where the Interstate Medical Licensure Compact (IMLC) plays a pivotal role. Launched in 2017, the IMLC is an innovative solution designed to streamline the licensing process for physicians seeking to practice in multiple states.

With telemedicine and locum tenens positions gaining prominence, the IMLC is an essential tool for physicians looking to navigate the complexities of multistate licensure. By simplifying the process of obtaining medical licenses across different states, the IMLC ensures that physicians can focus on providing high-quality care to their patients while reducing administrative burdens.

In this blog, we'll take a closer look at the Interstate Medical Licensure Compact, its benefits, eligibility criteria, application process, and some challenges physicians may face when utilizing it.

What Is the Interstate Medical Licensure Compact?

The Interstate Medical Licensure Compact (IMLC) is an agreement between participating states and jurisdictions that allows physicians to apply for medical licensure in multiple states through a unified process. This compact enables eligible physicians to submit a single application and, upon verification of their credentials, apply for licensure in additional states without the need to undergo multiple, separate application processes.

Launched in 2017, the IMLC has grown rapidly and, as of 2025, includes over 41 states and jurisdictions. The compact is designed to expedite licensure for physicians in states that have a high demand for healthcare services, including rural and underserved areas. It also supports telemedicine practices, allowing physicians to care for patients in multiple states more efficiently.

States Participating in the IMLC (As of 2025)

The IMLC currently includes 41 states, the District of Columbia, and Guam. Participation is categorized into fully active, pending implementation, and non-member states.

Fully Participating States and Jurisdictions

These states and jurisdictions are actively issuing licenses through the IMLC:

• Alabama
• Arizona
• Colorado
• Delaware
• District of Columbia
• Florida
• Georgia
• Guam
• Idaho
• Illinois
• Indiana
• Iowa
• Kansas
• Kentucky
• Louisiana
• Maine
• Maryland
• Michigan
• Minnesota
• Mississippi
• Missouri
• Montana
• Nebraska
• Nevada
• New Hampshire
• New Jersey
• North Dakota
• Ohio
• Oklahoma
• Pennsylvania
• South Dakota
• Tennessee
• Texas
• Utah
• Vermont
• Washington
• West Virginia
• Wisconsin
• Wyoming

States with IMLC Legislation Passed but Not Yet Implemented

• Arkansas
• Rhode Island

States with Pending Legislation (2025)

• Massachusetts
• New Mexico
• New York
• North Carolina

States Not Participating in the IMLC (as of 2025)

• Alaska
• California
• Oregon
• South Carolina
• Virginia
• Puerto Rico
• U.S. Virgin Islands

Eligibility Criteria for Physicians

Not all physicians are eligible for the IMLC, and it’s essential to meet specific criteria to apply. Below are the key eligibility requirements:

1. State of Principal License (SPL): Physicians must hold a full, unrestricted medical license in a participating state. This state is considered the State of Principal License (SPL) and serves as the primary state where the physician practices.
2. Residency or Practice Location: Physicians must either reside in, practice in, or have a primary employment location within the SPL.
3. Board Certification or Board Eligibility: Physicians must be board-certified or board-eligible in a specialty recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA).
4. Clean Professional Record: Physicians must have no history of disciplinary actions or felony convictions in any state.
5. Educational Background: Physicians must have graduated from an accredited medical school and completed an ACGME-accredited residency program.

Once these eligibility criteria are met, physicians can apply for a Letter of Qualification (LOQ), which is essential for obtaining licenses in other compact states.

Application Process for the IMLC

The application process through the IMLC is straightforward, consisting of several steps:

1. Determine Eligibility: Physicians must first ensure that they meet the eligibility criteria set forth by the IMLC. This is a critical step, as failure to meet the requirements will prevent participation in the compact.
2. Submit Application: Once eligibility is confirmed, physicians submit an application to the IMLC, including necessary documentation such as their medical education history, training records, and proof of board certification.
3. Credential Verification: The State of Principal License (SPL) will verify the physician’s credentials. This includes confirming educational background, medical training, and reviewing any history of disciplinary actions.
4. Letter of Qualification (LOQ): Upon successful credential verification, physicians will receive a Letter of Qualification (LOQ). This letter is valid for 12 months and serves as a basis for applying for medical licensure in other compact states.
5. Apply for Licenses: Using the LOQ, physicians can then apply for licensure in other participating states. Each state will process the application and issue a medical license if all requirements are met.
6. State Processing: Each compact state will have its own process for reviewing and issuing licenses. However, since the physician’s credentials have already been verified through the SPL, the process is typically much faster compared to traditional state licensure applications.

The IMLC drastically reduces the time and complexity typically associated with obtaining licenses across multiple states.

Key Benefits of the IMLC

1. Expedited Licensure Process: Traditional medical licensure can take several months. However, with the IMLC, the process is streamlined. In 2024, the average processing time for a Letter of Qualification was just 43 days, with an additional 20 days required for license issuance. This expedited process allows physicians to start practicing in other states much quicker.

2. Reduced Administrative Burden: One of the major advantages of the IMLC is the reduction in paperwork and fees. By consolidating multiple applications into one process, physicians spend less time dealing with administrative hurdles, allowing them to focus more on patient care.

3. Enhanced Career Flexibility: With the IMLC, physicians gain the ability to practice in multiple states without the need to navigate each state’s individual licensing process. This flexibility opens up new career opportunities, including locum tenens roles, telemedicine, and consulting across state lines.

4. Improved Access to Healthcare: The IMLC has the potential to improve healthcare access, especially in rural or underserved areas. Physicians can more easily travel to or practice in states with a shortage of medical professionals, helping to meet the growing demand for healthcare services.

5. Telemedicine Support: As telemedicine becomes more widespread, the IMLC facilitates physicians’ ability to provide virtual care across state lines. This is especially beneficial for physicians practicing telehealth, allowing them to reach a broader patient base in different states.

Challenges and Considerations for Physicians

While the IMLC offers numerous benefits, there are some challenges and considerations to keep in mind:

1. State Participation: Not all states participate in the IMLC. Physicians should verify that their desired states are part of the compact before applying. Currently, more than 35 states are involved, but a few key states may not be part of the compact.

2. Disciplinary Actions: A history of disciplinary actions in one state can affect a physician’s eligibility for licensure in other compact states. Physicians must maintain a clean professional record to remain eligible.

3. Renewal Requirements: To remain part of the IMLC, physicians must maintain their State of Principal License (SPL) status. Each state may also have its own renewal requirements, and physicians must ensure they meet these to continue practicing across state lines.

Key Takeaways

The Interstate Medical Licensure Compact (IMLC) is an essential tool for physicians looking to expand their practices across multiple states. By streamlining the licensure process, reducing administrative burdens, and enhancing professional mobility, the IMLC benefits both physicians and patients alike. It’s particularly advantageous for telemedicine practitioners and locum tenens providers seeking to reach underserved areas.

As the healthcare industry continues to evolve, initiatives like the IMLC play a crucial role in adapting to the increasing demand for healthcare professionals and improving access to care across state lines.

DirectShifts Licensing Services

At DirectShifts, we understand that navigating the complexities of medical licensure can be daunting. That’s why we offer comprehensive licensing services to help physicians through the IMLC process. Whether you need assistance with obtaining licenses in new states or managing renewals and compliance, our team of experts is here to support you every step of the way. Visit our Healthcare Licensing Services page to learn more about how we can help you simplify the licensing process and expand your practice.