Interstate Medical Licensure Compact 2026: Complete Guide

Introduction

The Interstate Medical Licensure Compact (IMLC) has transformed how physicians obtain licenses to practice in multiple states. Since its creation, the compact has processed over 25,000 license applications and now includes 42 states plus Washington D.C. and Guam—covering approximately 80% of the U.S. physician population.

For physicians who practice telemedicine across state lines, work locum tenens assignments, or maintain practices in multiple states, the IMLC offers an expedited pathway to multi-state licensure. However, it's crucial to understand what the IMLC is and isn't: it provides expedited licensure, not a single multi-state license.

This comprehensive guide covers everything you need to know about the Interstate Medical Licensure Compact in 2026, including participating states, eligibility requirements, the application process, and the significant upcoming change: Michigan's withdrawal effective March 28, 2026.

What Is the Interstate Medical Licensure Compact?

Key Concept: Expedited Licensure, Not a Multi-State License

The IMLC is not a single license that allows you to practice in multiple states. Instead, it provides:

Each state still issues its own individual license. The IMLC simply makes it faster and easier to obtain those licenses through a single application.

How the IMLC Works

1. Single Application: Apply through the IMLC portal
2. Eligibility Verification: IMLC confirms you meet compact requirements
3. State Selection: Choose which participating states you want licenses in
4. Separate Licenses Issued: Each state issues its own license
5. Individual Renewal: Renew each state license according to that state's rules

IMLC Participating States (2026)

As of January 2026, 42 states plus Washington D.C. and Guam participate in the IMLC.

Current Member States

*Limited participation (not eligible as State of Principal Licensure) **Withdrawing March 28, 2026

States NOT Participating

As of January 2026, these states have NOT joined the IMLC:

• California
• New York
• Oregon
• Arkansas (implementing)

Critical Update: Michigan Withdrawal

Michigan is withdrawing from the IMLC effective March 28, 2026.

Legislation: MCL 333.16189 (2023 Public Act 124)

If you need a Michigan license, apply through IMLC before March 28, 2026, or plan to apply directly to Michigan after that date.

IMLC Eligibility Requirements

Approximately 80% of U.S. physicians meet IMLC eligibility criteria. Requirements include:

Basic Eligibility Criteria

State of Principal Licensure (SPL)

Your SPL is the state where you can demonstrate the strongest connection. This is typically the state where you:

1. Have your primary residence, OR
2. Practice medicine the majority of the time, OR
3. Completed most recent medical training

Important: Connecticut and Vermont are not currently eligible as States of Principal Licensure. You can obtain IMLC licenses for these states only if you qualify through another SPL state.

IMLC Application Process

Step 1: Verify Eligibility

Before applying, confirm you meet all eligibility criteria:

• □ Valid medical degree (MD/DO or ECFMG certified)
• □ Completed accredited residency
• □ Board certified (or 5+ years active practice)
• □ Clean disciplinary history
• □ No criminal convictions
• □ No DEA restrictions
• □ Not excluded from Medicare/Medicaid
• □ Active unrestricted license in SPL state

Step 2: Create IMLC Account

1. Visit imlcc.org
2. Create an account
3. Complete the pre-application questionnaire
4. Receive eligibility determination

Step 3: Complete Application

1. Submit application through IMLC portal
2. Provide required documentation:
   • Identification
   • Medical school transcripts
   • Residency verification
   • Board certification documentation
   • SPL license information
3. Pay IMLC application fee (~$700)

Step 4: Select States

1. Choose which participating states you want licenses in
2. Pay each state's individual licensing fee
3. Meet any state-specific requirements

Step 5: License Issuance

1. IMLC verifies credentials with state medical boards
2. Each selected state reviews and issues license
3. Typical processing time: 2-4 weeks

IMLC Fees

Application Fees

Sample Total Cost (3 States)

Renewal Fees

IMLC licenses renew according to each state's normal schedule and fees. There is no separate IMLC renewal fee—you renew directly with each state.

Benefits of IMLC

Speed

Convenience

• Single application for multiple states
• Centralized credential verification
• Streamlined documentation process
• Online application portal

Cost Efficiency

• Reduced administrative burden
• Fewer duplicate credentialing fees
• Time savings translate to earlier practice start

Limitations of IMLC

What IMLC Doesn't Do

1. Not a multi-state license: Each state issues separate licenses
2. Doesn't waive state requirements: CME, renewals follow state rules
3. Doesn't cover non-participating states: California, New York, Oregon not included
4. Doesn't eliminate state fees: You still pay each state's licensing fee
5. Doesn't guarantee approval: States can still deny licenses

Disciplinary Reciprocity

If a participating state takes disciplinary action against your license:

• All IMLC states are notified
• Other states may initiate their own investigations
• Disciplinary actions may affect all your IMLC-issued licenses

This interconnection is both a benefit (consistent standards) and a risk (widespread impact of any disciplinary issue).

IMLC and Telemedicine

The IMLC has become increasingly important for telemedicine practice:

Why IMLC Matters for Telemedicine

• Telemedicine appointments occur in the patient's state
• You must be licensed in the state where the patient is located
• IMLC makes obtaining multiple licenses practical
• Post-COVID telemedicine expansion has increased multi-state practice

Telemedicine Considerations

Who Should Use IMLC?

Ideal Candidates

• Telemedicine physicians: Practice across multiple states
• Locum tenens physicians: Work temporary assignments in various states
• Border-region physicians: Practice near state lines
• Health system physicians: Systems with facilities in multiple states
• Emergency/disaster response: Need rapid multi-state licensing capability

May Not Need IMLC

• Physicians practicing in a single state
• Physicians only needing licenses in California, New York, or Oregon
• Physicians with disciplinary history (may not qualify)
• Physicians without board certification and <5 years practice

Key Takeaways

• IMLC includes 42 states + DC + Guam as of January 2026
• IMLC is expedited licensure, not a multi-state license—each state issues separate licenses
• Michigan withdrawing March 28, 2026—apply before this date if you need Michigan license
• ~80% of physicians qualify based on eligibility criteria
• Application fee is ~$700 plus individual state licensing fees
• Processing time: 2-4 weeks compared to 3-6 months traditional
• California, New York, Oregon not participating

Conclusion

The Interstate Medical Licensure Compact has revolutionized multi-state medical practice, making it feasible for physicians to serve patients across state lines through telemedicine or maintain practices in multiple states. With 42 participating states covering the majority of the U.S. population, the IMLC is an essential tool for modern medical practice.

However, remember that the IMLC provides expedited access to multiple separate state licenses—not a single portable credential. Each license must be renewed according to that state's requirements, and disciplinary actions can affect all your IMLC licenses.

Use CredentialMate to track your multi-state licenses, monitor renewal dates across all your IMLC states, and ensure CME compliance in each jurisdiction—keeping your expanded practice running smoothly.

Frequently Asked Questions

Is the IMLC a multi-state medical license?

No. The IMLC is an expedited pathway to obtaining multiple separate state licenses through a single application. Each participating state still issues its own individual license, which must be renewed according to that state's requirements.

How many states participate in the IMLC?

As of January 2026, 42 states plus Washington D.C. and Guam participate in the IMLC. Notable non-participating states include California, New York, and Oregon. Michigan is withdrawing effective March 28, 2026.

How much does it cost to apply through the IMLC?

The IMLC application fee is approximately $700. In addition, you pay each state's individual licensing fee, which varies by state (ranging from ~$60 in Wisconsin to ~$1,200 in California for traditional applications).

How long does IMLC processing take?

IMLC applications typically process in 2-4 weeks for multiple state licenses, compared to 3-6 months per state through traditional applications.

What happens to my Michigan IMLC license after March 28, 2026?

If you already have a Michigan license issued through IMLC before March 28, 2026, it remains valid according to Michigan's normal renewal schedule. However, after March 28, 2026, new applicants must apply directly to Michigan rather than through the IMLC.

References

[1]: Interstate Medical Licensure Compact https://www.imlcc.org

[2]: IMLC - Participating States https://www.imlcc.org/a-faster-pathway-to-physician-licensure/

[3]: IMLC - Eligibility Requirements https://www.imlcc.org/eligibility-requirements/

[4]: IMLC - How to Apply https://www.imlcc.org/how-to-apply/

[5]: IMLC - FAQs https://www.imlcc.org/faqs/

[6]: FSMB - Interstate Medical Licensure Compact https://www.fsmb.org/advocacy/interstate-licensure-compact/

[7]: Michigan Legislature - MCL 333.16189 (IMLC Withdrawal) https://www.legislature.mi.gov/