Interstate Medical Licensure Compact (IMLC): States, Eligibility and How to Apply (2026) 

Key Takeaways 

• The Interstate Medical Licensure Compact (IMLC) is an expedited licensing pathway, not a single national license. Each member state still issues and regulates its own license. 

• As of October 2026, 40 states, plus Washington, D.C., and Guam, are fully operational IMLC member jurisdictions; Alaska, Arkansas, New Mexico, and Rhode Island have enacted the compact and are in the process of implementing it. 

• The IMLC charges a $700 non-refundable Letter of Qualification (LOQ) fee, split between your State of Principal License board and the IMLCC; each state then charges its own license fee on top of that. 

• Your LOQ is valid for 365 days. Any member states you add during that window do not require you to requalify from the start. 

When you wanted to get a license in more than one state, you had to fill out separate applications, pay different fees, and wait different amounts of time at each state medical board. For qualified doctors, the Interstate Medical Licensure Compact (IMLC) changes that by letting them get licenses in multiple partner states with a single application. It is the fastest way for MDs and DOs to get into telehealth, take on locum tenens work, or join a medical group with members in more than one state. Credex Healthcare offers IMLC licensing services to walk you through eligibility, the LOQ application, state selection, and renewals in each new state. 

What Is the Interstate Medical Licensure Compact? 

The Interstate Medical Licensure Compact (IMLC) is a deal between partner states that makes it easier for doctors to get licenses in more than one state by using a single application. The Interstate Medical Licensure Compact Commission (IMLCC), a joint government agency made up of member states, runs the program, verifies eligibility, and issues the Letter of Qualification. Each member state still issues its own licenses, decides when they need renewal, and oversees its own doctors. The IMLC is not an “interstate medical license”; there is no such thing as a license that works in more than one state. 

The compact allows only MDs and DOs. Nurse practitioners have a different path through the Nurse Licensure Compact (NLC), and physician assistants have a different path through the PA Licensure Compact. For telemedicine licensing physicians, the IMLC is often the fastest route to legal practice authority in a new state, since many telehealth states are compact members. 

IMLC States: Full 2026 Member List 

The following areas have been full IMLC members since October 27, 2026. Doctors can join the union and get licenses in these areas. Hawaii, Connecticut, and Vermont all take part, but they can’t be a State of Principal Licensure (more on that in the next section). 

Jurisdiction	Full Member	SPL Restriction
Alabama	Yes	None
Arizona	Yes	None
Colorado	Yes	None
Connecticut	Yes	Cannot be SPL
Delaware	Yes	None
Florida	Yes	None
Georgia	Yes	None
Guam	Yes	None
Hawaii	Yes	Cannot be SPL
Idaho	Yes	None
Illinois	Yes	None
Indiana	Yes	None
Iowa	Yes	None
Kansas	Yes	None
Kentucky	Yes	None
Louisiana	Yes	None
Maine	Yes	None
Maryland	Yes	None
Michigan	Yes	None
Minnesota	Yes	None
Mississippi	Yes	None
Missouri	Yes	None
Montana	Yes	None
Nebraska	Yes	None
Nevada	Yes	None
New Hampshire	Yes	None
New Jersey	Yes	None
North Carolina	Yes	None
North Dakota	Yes	None
Ohio	Yes	None
Oklahoma	Yes	None
Pennsylvania	Yes	None
South Dakota	Yes	None
Tennessee	Yes	None
Texas	Yes	None
Utah	Yes	None
Vermont	Yes	Cannot be SPL
Washington	Yes	None
Washington D.C.	Yes	None
West Virginia	Yes	None
Wisconsin	Yes	None
Wyoming	Yes	None

Enacted, implementing (not yet issuing licenses): Alaska (joined June 23, 2026), Arkansas, New Mexico, Rhode Island. Check imlcc.com for go-live dates in each state. 

Non-members: California, New York, Oregon, South Carolina, Virginia, Massachusetts (pending legislation). Physicians targeting these states must apply through the standard state-by-state process. 

If you are credentialing in a new state, Credex Healthcare providing medical credentialing services in Pennsylvania, medical credentialing services in Illinois, and other member states as you expand your practice footprint. 

Who Is Eligible for an IMLC License? 

What Is a State of Principal License (SPL)? 

Why do you need a State Principal License (SPL)? The member state through which you enter the compact is your State of Principal Licensure. In order for your SPL to count, you must have a full, unrestricted medical license from a member state. If you live in a state and work there at least 25% of the time, your job is based there, or you use that state as your federal tax home, then that state is your SPL. Even though Connecticut, Hawaii, and Vermont are part of the compact, you can’t use them as your SPL. You can get licenses in those states through the compact, but you must enter through a different qualifying state. 

Physician Requirements 

To qualify for an IMLC license, you must meet all of the following at the time of application: 

Have a full, unrestricted license in your SPL state and have never been in trouble with the law, been convicted of a crime, or been given a controlled substance order. You must have graduated from a medical school that is accredited (LCME- or AOA-accredited for MDs and DOs, or an NCFMEA-determined school for international graduates), completed graduate medical education that is accredited by the ACGME or AOA, and passed the USMLE or COMLEX within the time limits set by the compact. You must be currently certified by the ATMS or AOA, and no state medical board investigations should be ongoing. 

VA doctors, for example, who have a federal license and mostly work in the federal system, should check with the IMLCC to make sure they are SPL-qualified, since their main place of work might not be in a single state. 

How the IMLC Works: From Letter of Qualification to State Licenses 

The IMLC process goes in a straight line. You apply through the IMLCC; your SPL board checks your qualifications and does a background check on you; your SPL gives you a Letter of Qualification (LOQ), which you use to choose partner states and pay their fees. After that, each state issues its own license. 

The Letter of Qualification (LOQ) 

The letter of intent (LOQ) is proof that you meet the IMLCC’s requirements. It comes from your SPL board and is good for 365 days from the date it was given. At any time during that window, you can add partner states to your LOQ without having to requalify from the beginning. You will just have to pay the fee for each state as you add it. Adding states after the LOQ has run out requires a new application and a fee of $700. 

IMLC Process Flow 

• Use the IMLCC portal to apply. 
• The SPL board checks credentials and does a background check. 
• The SPL board sends out the Letter of Qualification. 
• Pick member states and pay their fees. 
• Every state issues its own license. 

How to Apply for an IMLC License: Step by Step 

Step 1: Confirm your SPL and eligibility 

Read over the requirements to see if you qualify before you pay anything. The $700 application fee is non-refundable, even if you withdraw or your application is turned down. 

Step 2: Create your IMLCC application 

Create an account at imlcc.com. The application asks about your past licenses, education, training, and board certification. 

Step 3: Pay the $700 LOQ fee 

$300 of this goes to your SPL board and $400 goes to the IMLCC to pay for running the group. 

Step 4: Complete fingerprints and background check 

This step is based on what your SPL board says. Ink cards are used in some states, and Live Scan digital fingerprinting is used in others. Most of the time, applications slow down because of delays. 

Step 5: Respond to board requests promptly 

If your SPL board requests more information, such as a reason for a break, a proof form, or details about test tries, you must reply within the time frame they give you, or your application will be delayed. 

Step 6: Receive your Letter of Qualification 

Your SPL board sends your LOQ once it completes its review. Half of applicants receive their LOQ within 30 days of submitting their application. 

Step 7: Select member states and pay state fees 

To use in each target state, use your LOQ. It costs an extra $700 in fees in each state on top of the $700 you already paid. Before making a budget, look at the IMLCC fee table to see what each state’s present fee is. 

Step 8: Receive state licenses 

More than half of state licenses are issued to doctors within seven days of being found qualified. Times depend on the state and volume. 

Common reasons for delays are unclear SPL paperwork, incomplete fingerprinting, pending disciplinary disclosures that need to be explained, and applications sent to states that are still in the implementation phase. 

How Much Does the IMLC Cost? 

The Letter of Qualification costs $700 from the IMLCC. The fee is non-refundable and pays for one LOQ application. The IMLCC gets $400 and your SPL board gets $300. You can add more states to your LOQ as long as it is still valid. Each request costs $100 plus the state’s license fee. 

Example: a physician adding three states 

• LOQ fee: $700 

• State A license fee: varies (check IMLCC fee table) 

• State B license fee: varies 

• State C license fee: varies 

• Total: $700 + three state fees 

There is a wide range of state fees. Some states charge less than $100, while others charge several hundred dollars. For each member’s state, the IMLCC releases a fee table. Always use the most up-to-date numbers from that table instead of third-party amounts, which become outdated very quickly. For a comparison of licensing costs through standard state applications, see our breakdown of medical licensing costs across the US. 

How Long Does the IMLC Take? 

Based on data from 2024, the IMLCC says that 45% of applicants get their Letter of Qualification in 30 days or less after submitting an application, and more than 51% of state licenses are given out within seven days of a doctor being confirmed to be qualified. In real life, many doctors get their LOQ in two to four weeks if their application is complete, and their SPL board doesn’t have any questions. 

It takes longer if fingerprints or verification papers are missing or incomplete, a gap in clinical practice needs to be explained, a previous judicial report is being reviewed, or you’re applying to a state that is still finishing its compact implementation. You can take steps before you submit your application. See our guide on ways to get your medical license faster for steps you can take before submitting. 

Renewing Your IMLC Licenses 

There is not a single IMLC renewal cycle. Instead, each state’s license renews its own time. You will have to pay the renewal fee and meet the CME requirements for each state separately. You don’t have to go to each state board separately for every renewal because the IMLCC lets you do it through its portal when it’s available. Check out the IMLCC’s current renewal workflow at imlcc.com, as the process has continued to evolve. Managing multi-state license renewals across several compact states is an area where a licensing support team saves meaningful time each cycle. 

IMLC vs. Applying State by State 

Factor	IMLC	Standard State Application
Speed	Often weeks for the LOQ; days for many state licenses after	60–120+ days per state, no coordination
Cost	$700 LOQ + state fees	Full application fee per state, no offset
Paperwork	One central application, then state fees	Separate application to each state board
Who qualifies	MDs and DOs in member states meeting SPL criteria	Any licensed physician regardless of state
Which states	42+ member jurisdictions (Oct 2026)	All 50 states and territories

The IMLC is not the best way to go if the state you want to work in is not a member (like California, New York, Oregon, South Carolina, or Virginia), if you are not board-certified, or if you have already tried this route more than once. Next, read about how to get licensed in multiple states through endorsement and standard applications. For routes that aren’t compact, an FCVS credential application can speed up the checking of original sources across multiple state boards. 

After Your License: Credentialing in Each New State 

Even though a new state license lets you legally work, it doesn’t let you bill. Before you can send claims to Medicare, Medicaid, or commercial insurers, each state you add through the IMLC still needs its own payer credentialing. That means making changes to your CAQH ProView profile, applying to be a provider with each payer, applying for hospital privileges if you work in a facility, and signing up for a DEA registration and a state-controlled substance registration in states that need them. 

Check each state’s rules on providing controlled substances through telemedicine before you start. Some states require more than just a license to register. Our telehealth credentialing requirements guide outlines the steps for each payer, and our locum tenens credentialing guide explains what hospital medical staff offices need from you before you start working. 

Credex Healthcare takes care of medical credentialing and insurance credentialing in every state, which means that your licenses quickly become valid authority. If you want to know whether licensing or credentialing comes first, the short answer is that they both happen at the same time, and we handle both. 

Licensed in a new state through the IMLC? Credex Healthcare can credential you with its payers too. See our services for insurance credentialing in each new state. 

How Credex Healthcare Helps with IMLC Licensing 

Credex Healthcare checks your qualifications and SPL, helps you fill out and send in your LOQ, helps you choose your state and keep track of your fees, responds to board requests, and renews your licenses when they expire. Once you get your license, our team moves right on to licensing and enrolling payers in each new state. This way, there’s no delay between getting your license and being able to bill. 

Run a free eligibility check to see if you meet the requirements. This will also help you choose which state should be your SPL. We offer medical licensing services across all compact member states and can flag SPL issues before you pay a non-refundable application fee. When you’re ready to move, let Credex handle your IMLC application from start to licensure. 

FAQs 

What is the Interstate Medical Licensure Compact?

While the Interstate Medical Licensure Compact (IMLC) is a deal between member states, it speeds up the process for qualified MDs and DOs to get licenses in different states by letting them use a single application and a Letter of Qualification from their State of Principal Licensure board.

How many states are in the IMLC?

There are 40 states and Washington, D.C., as of October 2026. Alaska, Arkansas, New Mexico, and Rhode Island have signed the compact and are now implementing it. Guam and Alaska are fully active IMLC members. The full list of members can be found in the table above.

Is my state in the IMLC?

Arizona, New York, Florida, and Texas. Florida and Texas are full members of the IMLC. As of October 2026, California and New York are not members. Doctors who want to work in those states must go through the normal state registration process.

How much does an IMLC license cost?

The IMLCC charges a $700 LOQ fee. Of that amount, $300 goes to your SPL board, and $400 goes to the IMLCC. It costs $100 plus the license fee to add states while your LOQ is still good.

How long is an IMLC Letter of Qualification valid?

365 days from the date of issue. You can add member states to your LOQ at any point during that window without requalifying.

Can nurse practitioners or physician assistants use the IMLC?

No. There are only MDs and DOs in the IMLC. The Nurse Licensure Compact (NLC) is used by nurse practitioners when it is available. The PA Licensure Compact is for physician assistants and has a smaller effect. Check to see which states are currently members before making plans around it.

Does an IMLC license let me bill insurance in the new state?

No. Even if you have a license to practice law, you still need to get client credentials, CAQH updates, hospital privileges (if needed), and DEA and state controlled-substance registrations before you can bill.

How do I renew IMLC licenses?

Each state has its own plan for when and how much to pay to update a license. To renew, participating states can use the IMLCC site. Visit imlcc.com to see what registration choices are available in each partner state right now.

Conclusion 

If you are eligible, the Interstate Medical Licensure Compact is the easiest way for MDs and DOs to start practicing in multiple states without filling out a separate application for each board. It makes the LOQ stage more efficient for telehealth, locum tenens work, or practices that operate in more than one state. Most doctors don’t think about what comes after getting their license: getting credentialed and signed up with payers in each new state determines when you can actually bill, and these steps happen at the same time as getting your license, not after it.