What Are Medical Licensure Compacts?
Licensure compacts are agreements between states that make it easier for professionals to obtain licenses in multiple jurisdictions. In healthcare, three major compacts exist for different types of providers:
- IMLC: Interstate Medical Licensure Compact (for MDs and DOs)
- NLC: Nurse Licensure Compact (for RNs and LPNs)
- APRN Compact: Advanced Practice Registered Nurse Compact (for APRNs, including NPs, CRNAs, CNSs, and CNMs)
Each compact is profession-specific, and they are not interchangeable.
IMLC: For Physicians (MDs and DOs)
The Interstate Medical Licensure Compact helps physicians obtain licenses in multiple states through a centralized, streamlined process. It does not issue one license, but makes it easier to apply and qualify in each member state.
- Eligibility based on board certification, clean history, and SPL residency
- Valid for full, unrestricted practice in each state
- Popular for telehealth, locum tenens, and multi-state groups
NLC: For Registered and Licensed Practical Nurses
The Nurse Licensure Compact offers a true multistate license. If a nurse holds an NLC license in their home state, they can practice in any other compact state without getting additional licenses.
- One license, multiple states
- Must declare a compact state as your primary residence
- Accepted for in-person and telehealth nursing roles
The NLC is widely adopted and very effective for travel nurses and virtual care support.
APRN Compact: For Advanced Practice Nurses
This is the least implemented of the three, but it's gaining ground. It would allow NPs, CRNAs, CNSs, and CNMs to hold a multistate license for advanced practice nursing. As of 2025, it still needs more state participation to become active.
- Only a few states have enacted the compact so far
- Still requires separate state licensing in most cases
- Targeted at NPs and CRNAs doing telehealth or cross-border practice
Comparison Table
| Feature | IMLC | NLC | APRN Compact |
|---|---|---|---|
| Provider Type | MDs, DOs | RNs, LPNs | NPs, CRNAs, CNSs |
| Licensing Model | One application, multiple licenses | One license, multiple states | One license, multiple states (once active) |
| Status | Active | Active | Pending wider adoption |
| State Residency Required | Yes (SPL rules) | Yes | Yes |
Final Thoughts
If you’re a physician, the IMLC is your path to efficient multistate licensing. If you’re a nurse, check whether your state participates in the NLC or APRN Compact. Know which compact applies to you — and plan your licensure strategy accordingly. The right compact makes multistate practice faster, safer, and more scalable.