How to Get Licensed in Multiple States: A Physician’s Guide

Key Takeaways 

• Getting licensed in multiple states usually comes down to two paths: applying directly to each state medical board or using the Interstate Medical Licensure Compact to speed things up.  

• The IMLC now includes 44 member states plus Washington, D.C., and Guam, covering 46 jurisdictions as of mid-2026, though Hawaii and Vermont can’t be used as a state of principal licensure.  

• Traditional state-by-state licensing can take 9 to 18 months across several states. The IMLC often gets that down to 4 to 10 weeks.  

• A Letter of Qualification from your State of Principal Licensure is the entry point for the compact, and it typically takes 2 to 4 weeks to process.  

• Physicians who work locum tenens, telemedicine across state lines, or split time between multiple facilities benefit most from multi-state licensure.  

• Every license comes with its own renewal schedule, CME requirements, and fees, and maintaining several at once needs an active tracking system, not a mental note.  

• Not every state participates in the IMLC. California, New York, and Oregon are among the states where physicians still must license directly. 

Can a Physician Be Licensed in Multiple States? 

Yes, and you can be licensed in as many as you want. There is no limit on how many states a doctor can practice medicine in. This includes states where they provide in-person care, use telemedicine, or do locum tenens work. Each state issues its own license and has its own rules, so a license in one state doesn’t automatically mean you have one in another.  

How quickly a doctor can get there has changed. Now, getting licensed in more than one state comes down to a single choice: go through each medical board individually in each state, or use the Interstate Medical Licensure Compact to move faster through states that are a part of it. 

Why Physicians Need Multiple State Medical Licenses 

Over the past ten years, the reasons physicians have changed a lot. Telemedicine is what makes it work. A doctor who sees patients almost always needs to be licensed in the state where the patient is at the time of the visit, not just the state where the doctor works. A practice that treats people from five states must have a doctor who is licensed in all five, or it can’t properly treat those patients from afar.  

The second main driver is locum tenens work. When they go to hospitals and clinics in other states to fill short-term openings, doctors need to make sure they have a current license. The faster they get that license, the sooner they can start their job. The same rule applies to academic and research doctors who work as consultants for institutions in different states. It also applies to doctors who are moving and want to keep their old license valid while getting a new one.  

Rural and neglected areas add another layer. Because some states face a growing doctor shortage, hospitals often need to hire doctors from other states to staff their facilities. This is especially true in specialized areas where local hiring has stopped, which is one reason the compact was created. 

How to Get a Medical License in Multiple States 

To go the usual way, you have to send a full application to each state’s medical board. Every application needs the same basic information: medical school records, proof of residency, board credentialing, work history, and a history of malpractice claims. However, each board reviews the application on its own timetable and using its own forms.  

This path only makes sense in a few situations: when a doctor needs a license in only one or two more states, when the target state isn’t part of the compact, or when the doctor doesn’t yet meet the compact’s requirements. When those situations aren’t present, the compact is much faster for most doctors who are pursuing three or more states. 

State-by-State Medical Licensing Requirements 

Different states have different rules, but some requirements are always the same. A doctor needs a full record of their education and training, with proof from medical school and any residency or fellowship programs. If there is board certification, the governing board must verify it. Any history of malpractice or disciplinary action must be fully disclosed. Unexplained gaps in this history are a main reason an application is delayed.  

Beyond the baseline, some states have their own rules. A few require an exam under the law that covers medical practice rules in that state. Others require fingerprints and not only a national criminal record check, but also a state-level one. Some states limit how long a doctor can keep a valid license without working in that state before it expires. This matters for doctors who want a license in a state where they don’t plan to work full-time. 

What Is the Interstate Medical Licensure Compact? 

What is the Interstate Compact for Medical Licensure? IMLC members have agreed to make it easier for doctors to get licenses in other states. This doesn’t take away from each state’s power to issue its own licenses, though. No single license applies to everyone. Even though each state still issues its own licenses, the process moves faster because member states agree to use a single, shared approval process instead of each doing a full review from scratch.  

The compact has 46 participating jurisdictions as of mid-2026. It has 44 member states plus Washington, D.C., and the territory of Guam. Alaska was the most recent state to join. In June 2026, they signed the final paperwork to do so. States like California, New York, and Oregon are still not part of the compact, so doctors who want to work in those states still must apply directly. 

How the IMLC Process Works 

The first step is to find a State of Principal Licensure, or SPL. This is the state where the doctor holds their main, unlimited license and meets the compact’s residency or practice requirements. The doctor then applies to the IMLC Commission for a Letter of Qualification. The IMLC Commission checks the doctor’s qualifications once, nationally, instead of again for each state.  

After getting the Letter of Qualification, the doctor chooses which member state they want to get a license in. Then each state issues a full medical license. It does this under its own authority, but more quickly because a lot of the work to make sure the license is real already happened at the compact level. A doctor can apply to more than one state at once, or add more later if their needs change, without restarting the qualification process.  

Hawaii and Vermont should be called out. Right now, neither is a State of Principal Licensure, which means a doctor licensed in either state can’t join the compact. Even after joining the compact through a different qualifying SPL, a doctor can still use the compact process to get a license for Hawaii or Vermont. 

Which Physicians Can Use the IMLC? 

The doctor’s main license determines whether or not they are eligible. To be an SPL, a doctor must have a full, unrestricted medical license in a compact member state, board certification in a specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association, and no pending investigations or disciplinary action.  

If a doctor has a limited license, an open disciplinary action, or a criminal record involving certain offenses, they usually can’t apply through the compact. Instead, they need to apply directly to each state and go through that state’s full review process. Not as a way for doctors with problems in their record to get around the system, but to speed things up for doctors who are already fully trained. 

Documents Needed for Multi-State Licensing 

Most of the supporting material is the same whether you look at the deal as a whole or apply state by state. In almost all applications, you will need to show proof of your medical school diploma and transcripts, residency and fellowship completion certificates, board certification paperwork, a full work history with explanations for any gaps in employment that are too long, malpractice insurance history and claims records, and a current, valid photo ID from the government. 

The compact adds a document regular applications don’t need: the Letter of Qualification itself, which the IMLC Commission issues after the first round of checks. After that, it becomes proof that speeds up every other state license request, so keeping a copy handy saves time for every new state added to the license portfolio. 

How Long Does Multi-State Medical Licensing Take? 

A big gap exists between the two paths. Traditional state-by-state applications usually take 9 to 18 months to complete across several states, since each board reviews them separately and doesn’t share work between applications.  

The compact takes about two to four weeks to process the Letter of Qualification. Each new state license after that usually takes an extra one to three weeks. Through the compact, a doctor who wants to get licenses in three more states can probably get them all within four to ten weeks, which is much faster than the usual time frame. One report from the compact shows that more than half of licenses are issued within a week of receiving the Letter of Qualification. 

Common Challenges with Multiple State Licenses 

Some problems keep coming up for doctors who manage multiple licenses at the same time. Tracking renewal dates across states is hard because each state sets its own renewal cycle, usually every 1 to 2 years, and the dates don’t always align. Continuing education requirements also vary by state, both in the total number of hours needed and the specific topics that must be covered. For example, some states require training in implicit bias or how to prescribe opioids, while others do not.  

You must change your address or phone number with each state board separately because no single system handles it for all of them, unlike CAQH for patient credentialing. When doctors let their license expire in a state where they’re not working, it can take almost as long to get it back as it did to get it in the first place. This defeats the purpose of getting the license in the first place. 

How to Maintain Multiple Medical Licenses 

Instead of relying on memory or a bunch of renewal emails, use a specialized tracking system to track all your licenses. At a minimum, keep a simple spreadsheet with each state’s license number, expiration date, and CME requirements. Many doctors and practices that handle more than two or three states switch to a dedicated credentialing platform or professional credentialing support instead. This is because tracking CME, fees, and jurisprudence requirements while managing renewal schedules across multiple boards becomes difficult to do by hand.  

Getting reminders 90 days before each expiration date is better than waiting for a state board’s own renewal letter. This gives you time to find CME certificates or finish a needed course before the deadline. For a Compact license, this matters more because a delay can also affect the standing tied to the original Letter of Qualification. 

Multi-State Licensing Checklist for Physicians 

Most of what’s important is on a short list that you should keep on hand. Before choosing a method, make sure that the goal states are part of the IMLC. If you want the compact, make sure you are eligible for a State of Principal License. Get records of your schooling, training, and board certifications once, because you’ll use them for all applications. Tell everyone right away about any gaps in your work experience or malpractice cases and explain them. Keep separate records for each license, including expiration dates, CME hours, and state-specific standards. Give yourself 90 days of extra time before each renewal, instead of waiting for an automated reminder from the board. 

Frequently Asked Questions 

How can a physician get licensed in multiple states? 

You can apply directly to each state’s medical board or through the Interstate Medical Licensure Compact if the states you want to work in are members, and the doctor meets the requirements. 

How long does multi-state physician licensing take? 

The standard process takes nine to eighteen months and happens across several states. For most people, the compact cuts that time down to 4 to 10 weeks. 

What states are part of the IMLC? 

As of mid-2026, 46 regions, including 44 states, Washington, D.C., and Guam, were part of it. Some states that aren’t participating yet include California, New York, and Oregon. 

How does the Interstate Medical Licensure Compact work? 

A physician gets a Letter of Qualification from their main credentialing state, then requests individual, fast licenses from any active member states. 

Can a physician have medical licenses in multiple states at once? 

Yes, there is no limit. However, each license has its own due dates and CME requirements that must be tracked separately. 

Final Thoughts 

To get licensed in more than one state, a doctor needs to know which path is best for their situation. The Interstate Medical Licensure Compact has cut the time it used to take from 9 to 18 months to 4 to 10 weeks for doctors who meet the requirements and want to work in participating states. With 46 jurisdictions now on board, that’s pretty much the whole country covered. The traditional application process remains the only option for states not part of the compact. Doctors who gather their paperwork once and keep it ready to reuse will be rewarded.  

The real work starts with upkeep once the licenses are up and running. Multiple state boards don’t handle renewal dates, CME requirements, and address changes on their own. Doctors who have to do all of this while also managing a full clinical schedule often hire professional credentialing help to keep their licenses up to date, so they don’t have to worry about a quiet lapse undoing months of work they put into getting licensed in the first place.