Introduction
The Interstate Medical Licensure Compact (IMLC) provides an expedited pathway for physicians to obtain medical licenses in multiple states through a single application. As of January 2026, 42 states plus Washington D.C. and Guam participate in the compact—covering approximately 80% of the U.S. physician population.
Understanding which states participate is essential for physicians planning multi-state practice, telemedicine services, or locum tenens assignments. This guide provides the complete IMLC states list for 2026, including important updates about Michigan's upcoming withdrawal.
Complete IMLC Member States List (2026)
Full Member States (Can Serve as State of Principal Licensure)
These states can serve as your State of Principal Licensure (SPL) and issue IMLC licenses:
| Region | States |
|---|---|
| Northeast | Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, Pennsylvania, West Virginia |
| Southeast | Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia |
| Midwest | Illinois, Indiana, Iowa, Kansas, Michigan*, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin |
| Southwest | Arizona, Colorado, New Mexico, Oklahoma, Texas, Utah |
| West | Alaska, Hawaii, Idaho, Montana, Nevada, Washington, Wyoming |
| Territories | Washington D.C., Guam |
*Michigan withdrawing effective March 28, 2026
Limited Participation States
These states participate but cannot serve as State of Principal Licensure:
| State | Limitation |
|---|---|
| Connecticut | Can receive IMLC license, cannot be SPL |
| Rhode Island | Can receive IMLC license, cannot be SPL |
| Vermont | Can receive IMLC license, cannot be SPL |
You can obtain an IMLC license for these states if you qualify through another SPL state, but you cannot use these states as your primary state for IMLC applications.
States Implementing (Pending)
| State | Status |
|---|---|
| Arkansas | Legislation passed, implementation in process (effective August 5, 2025) |
States NOT Participating in IMLC
Major Non-Participating States
| State | Population Rank | Notes |
|---|---|---|
| California | 1st | Largest state not in IMLC |
| New York | 4th | Major medical market |
| Oregon | 27th | West coast non-participant |
Why These States Don't Participate
Each state has different reasons for non-participation:
California: Has not enacted IMLC legislation. California's medical board operates independently with its own licensing requirements.
New York: Uses a unique registration system (triennial, no CME required) that differs from most states. Has not joined interstate compacts.
Oregon: Has not enacted IMLC legislation despite neighboring states participating.
Critical Update: Michigan Withdrawal
Timeline
| Date | Event |
|---|---|
| 2023 | 2023 Public Act 124 passed with IMLC sunset provision |
| March 28, 2025 | 12-month withdrawal notice period begins |
| March 28, 2026 | Michigan withdrawal effective |
Impact
- Before March 28, 2026: Michigan continues processing IMLC applications
- After March 28, 2026: Direct application to Michigan LARA required
- Existing licenses: Remain valid, renew directly with Michigan
Post-Withdrawal IMLC Count
After Michigan's withdrawal:
- 41 states + DC + Guam
- Still covers majority of U.S.
IMLC States by Region
Northeast Region (11 States)
| State | SPL Eligible | Notes |
|---|---|---|
| Connecticut | No (limited) | Can receive license only |
| Delaware | Yes | Full member |
| Maine | Yes | Full member |
| Maryland | Yes | Full member |
| Massachusetts | Yes | Full member |
| New Hampshire | Yes | Full member |
| New Jersey | Yes | Full member |
| Pennsylvania | Yes | Full member |
| Rhode Island | No (limited) | Can receive license only |
| Vermont | No (limited) | Can receive license only |
| West Virginia | Yes | Full member |
Not participating: New York
Southeast Region (10 States)
| State | SPL Eligible | Notes |
|---|---|---|
| Alabama | Yes | Full member |
| Florida | Yes | Full member |
| Georgia | Yes | Full member |
| Kentucky | Yes | Full member |
| Louisiana | Yes | Full member |
| Mississippi | Yes | Full member |
| North Carolina | Yes | Full member |
| South Carolina | Yes | Full member |
| Tennessee | Yes | Full member |
| Virginia | Yes | Full member |
All major Southeast states participate
Midwest Region (12 States)
| State | SPL Eligible | Notes |
|---|---|---|
| Illinois | Yes | Full member |
| Indiana | Yes | Full member |
| Iowa | Yes | Full member |
| Kansas | Yes | Full member |
| Michigan | Yes* | *Withdrawing March 28, 2026 |
| Minnesota | Yes | Full member |
| Missouri | Yes | Full member |
| Nebraska | Yes | Full member |
| North Dakota | Yes | Full member |
| Ohio | Yes | Full member |
| South Dakota | Yes | Full member |
| Wisconsin | Yes | Full member |
All Midwest states currently participate (Michigan until March 2026)
Southwest Region (6 States)
| State | SPL Eligible | Notes |
|---|---|---|
| Arizona | Yes | Full member |
| Colorado | Yes | Full member |
| New Mexico | Yes | Full member |
| Oklahoma | Yes | Full member |
| Texas | Yes | Full member |
| Utah | Yes | Full member |
All Southwest states participate
West Region (7 States + 2 Territories)
| State/Territory | SPL Eligible | Notes |
|---|---|---|
| Alaska | Yes | Full member |
| Hawaii | Yes | Full member |
| Idaho | Yes | Full member |
| Montana | Yes | Full member |
| Nevada | Yes | Full member |
| Washington | Yes | Full member |
| Wyoming | Yes | Full member |
| Washington D.C. | Yes | Full member |
| Guam | Yes | Full member |
Not participating: California, Oregon
State of Principal Licensure (SPL) Explained
What Is SPL?
Your State of Principal Licensure is the state through which you apply to the IMLC. It must be a state where you have a significant connection.
SPL Eligibility Criteria
Your SPL is typically the state where you:
- Have primary residence, OR
- Practice medicine majority of time, OR
- Completed most recent medical training, OR
- Have other significant connection
States That Cannot Be SPL
| State | Can Receive IMLC License | Can Be SPL |
|---|---|---|
| Connecticut | Yes | No |
| Rhode Island | Yes | No |
| Vermont | Yes | No |
If your only connection is to one of these states, you cannot use IMLC and must apply directly.
Planning Multi-State Practice with IMLC
Coverage Analysis
With IMLC membership, you can potentially cover:
| Metric | Value |
|---|---|
| States accessible | 42 (41 after March 2026) |
| U.S. population covered | ~80% |
| Major markets included | TX, FL, PA, IL, OH, GA, NC |
| Major markets excluded | CA, NY, OR |
Strategic Considerations
If you need California or New York:
- Apply directly to those states separately
- IMLC cannot help with these licenses
- California: Traditional application to MBC
- New York: Application to NYSED
For maximum coverage:
- IMLC for 42 states
- Direct California application
- Direct New York application
- = Access to 44 states total
Telemedicine and IMLC Coverage
Coverage Map for Telemedicine
| Patient Location | IMLC Available? |
|---|---|
| Most U.S. states | Yes (42 states) |
| California | No—direct application required |
| New York | No—direct application required |
| Oregon | No—direct application required |
| Michigan (after March 2026) | No—direct application required |
Telemedicine Planning
For comprehensive telemedicine coverage:
- Apply through IMLC for all participating states you need
- Apply directly to California if serving CA patients
- Apply directly to New York if serving NY patients
- Consider Oregon if serving Pacific Northwest patients
- Plan for Michigan transition if serving MI patients
Key Takeaways
- 42 states + DC + Guam currently participate in IMLC (January 2026)
- Michigan withdrawing March 28, 2026—apply before deadline if needed
- California, New York, Oregon are major non-participants
- Connecticut, Rhode Island, Vermont have limited participation (can't be SPL)
- Arkansas implementing (effective August 5, 2025)
- ~80% of U.S. population covered by IMLC states
Conclusion
The IMLC provides access to 42 states through a single application, making multi-state practice more accessible than ever. While notable states like California and New York don't participate, the compact covers the majority of the U.S. population and includes major medical markets across all regions.
Understanding which states participate—and the upcoming Michigan withdrawal—helps physicians plan their licensing strategy effectively. Use CredentialMate to track your licenses across IMLC and non-IMLC states, monitor compact membership changes, and ensure continuous compliance in every state where you practice.
Frequently Asked Questions
How many states are in the IMLC in 2026?
As of January 2026, 42 states plus Washington D.C. and Guam participate in the IMLC. After Michigan's withdrawal on March 28, 2026, the count will be 41 states plus DC and Guam.
Is California in the IMLC?
No. California does not participate in the IMLC. Physicians must apply directly to the Medical Board of California for licensure.
Is New York in the IMLC?
No. New York does not participate in the IMLC. Physicians must apply directly to the New York State Education Department (NYSED) for licensure.
What's the difference between full and limited IMLC participation?
Full member states can serve as your State of Principal Licensure (SPL) and issue IMLC licenses. Limited participation states (Connecticut, Rhode Island, Vermont) can issue you an IMLC license but cannot serve as your SPL—you must qualify through another state.
When is Michigan leaving the IMLC?
Michigan's withdrawal is effective March 28, 2026. Until that date, Michigan continues to process IMLC applications. After that date, physicians must apply directly to Michigan LARA.
References
[1]: Interstate Medical Licensure Compact - Participating States https://www.imlcc.org/a-faster-pathway-to-physician-licensure/
[2]: IMLC - How to Apply https://www.imlcc.org/how-to-apply/
[3]: IMLC - FAQs https://www.imlcc.org/faqs/
[4]: FSMB - Interstate Medical Licensure Compact https://www.fsmb.org/advocacy/interstate-licensure-compact/
[5]: Michigan Legislature - MCL 333.16189 (IMLC Withdrawal) https://www.legislature.mi.gov/
[6]: FSMB - Contact State Medical Boards https://www.fsmb.org/contact-a-state-medical-board/