The Interstate Medical Licensure Compact, explained

Telehealth programs like to mention the Interstate Medical Licensure Compact because it lets one physician hold licences in many states without repeating the whole application each time. It is real and useful. It is also routinely described as something it is not.

What the compact does

The IMLC is an agreement among states, administered by the Interstate Medical Licensure Compact Commission. A physician who holds a full, unrestricted licence in a member state that qualifies as their state of principal licence (broadly: where they live, practise at least a quarter of the time, are employed, or file taxes) applies once to that state for a letter of qualification. With the letter, the physician can request licences from any other member states. Each of those states issues its own full licence, charges its own fee and applies its own renewal and continuing-education rules. The physician is then licensed in each state in the ordinary sense and is subject to each board's discipline.

Eligibility is deliberately narrow: a specialty board certification, no disciplinary history, no criminal history, and a passed licensing exam within a set number of attempts, among other requirements. A physician with a board action on their record generally cannot use the compact.

What the compact does not do

• It does not create a multistate or national licence. There is no "compact licence" you can hold instead of a state licence.
• It does not change the rules of practice. A physician who obtains a Kansas licence through the compact practises under Kansas law, including Kansas telehealth rules, exactly as one licensed the ordinary way.
• It does not cover nurse practitioners or physician assistants. Nurses have their own compact (the Nurse Licensure Compact), which works differently, and a PA compact is in early implementation; neither is covered on this site's cards.
• It is not a credential. Prescribers sometimes say "compact licensed" as if it were an endorsement. It means they were eligible for the expedited route.

Who participates

On the Commission's snapshot (stats updated August 6, 2026, information as of July 31, 2026) there were 44 member states plus the District of Columbia and Guam, and 59 participating boards. Six states were not members: California, Massachusetts, New York, Oregon, South Carolina and Virginia. The Commission's map records Massachusetts and New York as having compact legislation introduced but not enacted.

Not every member is at the same stage. The map marks a few states as having enacted the compact but still implementing it, so they were not yet issuing letters of qualification or compact licences on the check date: Alaska (which the Commission lists as joining June 26, 2026), Arkansas, New Mexico and Rhode Island. Hawaii and Vermont issue compact licences but cannot serve as a state of principal licence. Each state page carries the note that applies.

What this means when you check a prescriber

Nothing changes in the search. Open the board lookup for the state you were in during the visit and search the name. A licence obtained through the compact appears as a normal licence, sometimes with a note that it was issued via the compact. If the state is not a member, the prescriber needed to apply the long way or use another route the state recognises; that is more work for them, not a bar. If the state is a member and the prescriber is not on the lookup, membership does not help them; they are not licensed there.

The cross-state telehealth explainer covers the routes other than the compact, and the licence check explainer covers reading the record.

A note on the Commission's web address

The Commission's site is imlcc.com. The older imlcc.org domain no longer serves the Commission and, when we checked on September 4, 2026, showed unrelated content. Links on this site go to imlcc.com only; if you see imlcc.org cited elsewhere, treat it as stale.