By FlexMedStaff

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One of the many frustrations of being a physician in this country is that our medical licenses do not cross state lines. Instead, we must have a license in each state where we directly treat patients. This can include patients we treat in person or via telemedicine. It is advised that most physicians have multiple state medical licenses. Not only is it wise for locums practitioners to have multiple state licenses, but it can also be helpful for those practitioners in conventional roles or jobs.

Thankfully the Interstate Medical Licensure Compact (IMLCC) was created to streamline the process for physicians to obtain licenses in multiple states and for state boards to communicate more effectively.

If you are looking for a quick way to get one or many state medical licenses, consider getting a “Compact license.” If you are new to locums or a veteran, the Compact license offers a way to expedite getting a new state license. Not all states participate in the Compact, but you can get a new license extremely fast for the states that do. This article gives the 411 on the Compact license and how you can speed up getting your next medical license.  

IMLCC Basics

The traditional approach to getting a new state medical license was to apply to each state individually, which was time-consuming and expensive. To improve this process, the IMLCC has arranged agreements between states to work together to speed up obtaining a new license. Thru the IMLCC, physicians can get a new state medical license based on having another state license in good standing. The Compact license does not allow physicians to practice medicine in all states, only in states with agreements to extend a license based on another state’s endorsement.

Participating States

Sadly, not all states participate in the Compact license. Currently, the Compact license includes 34 states, including DC and the Territory of Guam. There are another eight states pending approval to participate in the IMLCC.

Eligible Physicians

Physicians looking to participate in the Compact license must fulfill professional qualifications and be able to designate a State of Principle License (SPL).

A physician shall have:

  1. Graduated from accredited medical school or select international schools.
  2. Completed ACGME or AOA graduate medical education program.
  3. Passed USMLE, COMLEX-USA or equivalent in 3 attempts or less
  4. Active board certification
  5. No history of disciplinary or criminal actions against them.

If the physician meets the criteria above, they can designate an SPL. Most states participating in the Compact license can act as an SPL, but few cannot. (See the Compact map on their website to know which states can serve as SPL.)

To designate a state as an SPL, the practitioner must have an unrestricted license in that state, and one of the following must apply:

  1. Permanent residency in that SPL state.
  2. Greater than 25% of the physician’s medical practice is in an SPL State.
  3. Physician is employed to practice medicine in an SPL state.

If the physician meets the professional qualifications and has a State they can designate as an SPL, they can proceed with registering for the compact license.


Each physician starts the registration process online. The IMLC will charge a non-refundable fee of $700 to initiate your application and designate an SPL state. Thus, ensure you have your ducks in a row and meet all the criteria outlined above and on the IMLCC’s website. Designating an SPL is not difficult nor time-consuming. It is relatively easy! The hardest part is finding time to get fingerprinted.  If you have done all the steps correctly, then you should be able to get a Compact license within a few weeks. The timing is based on which is your SPL state. Once the process is completed, you will receive an email with a “Letter of Qualification,” which will make it official that you have a Compact license. This Letter of Qualification will expire one year after you receive it.   

Getting More Licenses

Once you have received a Letter of Qualification, you can log back into the IMLCC website anytime within one year of receiving the Letter to get more state licenses quickly. The fees for each state will differ, ranging from $50-850. The IMLCC will charge a processing fee of $100 each time you request a new state license(s). For example, if you log in to get a new South Carolina license, you will be charged $580 for the state fees, and the IMLCC will add on their processing fee of $100. On the other hand, if you apply for two or more licenses simultaneously, then the IMLCC will only charge $100 per transaction. Therefore, you will save yourself a few bucks if you get all new licenses at once. Although it is state-dependent, many states will get you a new state license within 1-2 weeks, sometimes within a few days.

Renewing the Compact License

Unfortunately, the Compact license only stays active for one year once you receive the Letter of Qualification. Thus, you would be forced to pay another $700 to keep it active for another year. Most practitioners do not need the Compact license to be renewed every year. Even if you don’t keep the Compact license active, you will continue renewing the state licenses you obtained through the IMLCC on their website. Once again, you DO NOT need an active Compact license to keep your state licenses active.

Reapply for Letter of Qualifications

If you need additional licenses later on, you can reapply for the “Letter of Qualification” through the “LOQ Reapply” tab on the website. Depending on your timing and SPL state, reapplying for the Compact license may not require much additional work once you pay another $700.

State License Renewals

Any license that you obtain via the IMLCC, you will renew it on their website. Whether your letter of Qualification is expired or not, you will continue the state license on the website. In addition to the state renewal fees, the IMLCC will charge a processing fee of around $35. 

IMLCC Contact information

The IMLCC has excellent customer service. Don’t be afraid to reach out to them with questions. Call them at 303-997-9842 or email them at


The IMLCC is an excellent resource for physicians seeking to expedite obtaining a new license. It might be a bit expensive, but the time saved is incredible. More so, the stress avoided by not having to go thru the application process with each state to get a new medical license makes it worth the money. If you want medical licenses quickly, consider doing the Compact. Even if you need one medical license, you might find that going thru the IMLCC might be quicker and more convenient than applying directly to the state’s medical board. Consider using the IMCLCC to assist you with getting new state medical licenses when doing locums, telemedicine, or having greater flexibility in your career.

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