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IMLC Letter of Qualification: How the Process Works

The Interstate Medical Licensure Compact offers eligible physicians a faster route to licenses in participating states, and the Letter of Qualification is the first document in that route.

Last reviewed November 1, 2026. General information, not legal or compliance advice.

The basic idea

You choose a State of Principal License, and that state verifies your eligibility and issues a Letter of Qualification. You then use the letter to apply for licenses in other participating states, each of which still issues its own license and sets its own renewal rules.

Eligibility in general terms

Eligibility has included holding a full, unrestricted license in the state of principal license, a connection to that state such as primary residence or practice, and a clean disciplinary record, along with specified board certification or training. The exact criteria are set by the compact, so check the IMLC website.

Fees and timing

The compact charges its own fee, and each state charges a license fee, so the total grows with the number of states. The letter has a limited validity period. Both the amounts and the validity period can change, so confirm them with the IMLC before you apply. Our cost calculator lists a compact note per state when that information is recorded.

Not every state is a member

Membership changes as legislatures act. If a state you need is not a member, you apply to its board in the usual way.

Nurses and physician assistants

The IMLC is for physicians. See the guides on the nurse licensure compact and the PA compact.

Limits of this guide

Rules and fees change, and this guide is general information, so confirm the details with the relevant board or agency before you act.