Florida has a physician shortage. So does Texas. And Arizona, Nevada, and Montana. If you're an Emergency Medicine physician with an active Florida license, the opportunity to work shifts in adjacent states is real — but the credentialing barrier is formidable.
This article explains how multi-state physician licensure works, what the Interstate Medical Licensure Compact (IMLC) covers, and how SANNEXUS's national credentialing passport makes working across states dramatically faster.
The Multi-State Problem
A physician licensed in Florida cannot practice in Georgia without a Georgia license. Every state medical board issues its own license, and each state's credentialing office verifies it independently. If you want to work in three states, you need three licenses, three malpractice verifications, three DEA state registrations (in most states), and three credentialing cycles at each new facility.
For a hospitalist working locum assignments across the Southeast, that process can represent 6–12 months of delays and thousands in administrative costs before a single shift starts.
The Interstate Medical Licensure Compact (IMLC)
The IMLC was established in 2015 to address this. It creates a streamlined license application process for physicians who want to practice in multiple member states. As of 2026, 40 states participate in the Compact, including Florida, Georgia, Texas, North Carolina, and most of the Midwest and West.
Here's how IMLC works:
- You designate a State of Principal License (SPL) — the state where you primarily practice.
- You apply through the IMLC portal for additional state licenses. Your SPL state verifies your credentials and shares them electronically with requesting states.
- Each participating state still issues its own license, but the verification process is consolidated.
The typical IMLC timeline is 2–4 weeks per state — significantly faster than the 3–6 months required for a traditional application.
Important limitations: IMLC does not eliminate credentialing at the facility level. Even with an IMLC license in hand, each hospital still credentials you independently. IMLC solves the state board problem, not the hospital credentialing problem.
The Hospital Credentialing Layer (Where Most Delays Live)
Once you have state licenses, every hospital where you want to work must credential you separately. This process verifies:
- Primary source verification of all medical degrees and training
- Current and past state licenses (primary source, not copies)
- Board certification status (ABMS or AOA direct verification)
- DEA certificate
- National Practitioner Data Bank (NPDB) query
- Malpractice insurance coverage verification and claims history
- Current hospital privileges at any other facility
- Peer references (usually 3 physicians who can attest to clinical competency)
At most hospitals, this takes 90–120 days. Some systems with efficient MSO (Medical Staff Office) processes complete it in 60 days. A few legacy systems with manual workflows can take 180 days.
Every time you start at a new hospital — even in the same state — the cycle starts over.
What SANNEXUS Does Differently
SANNEXUS's physician credentialing passport was designed to solve the hospital layer.
When you create your SANNEXUS passport, we collect and continuously verify every element of your credentialing file:
- Your medical school diploma and transcripts (primary source)
- Residency and fellowship completion letters
- All active state licenses (with auto-expiration tracking)
- Board certifications
- DEA certificate
- Malpractice coverage and claims history
- NPDB query
- Peer references on file
When a SANNEXUS-networked hospital needs a physician, your passport is available immediately. Instead of starting a 90-day credentialing process, the hospital's credentialing team receives your pre-verified file. Standard credentialing review drops to 1–2 weeks.
For a physician working three states, this means:
- Complete credentialing once
- Add new states as you obtain IMLC licenses
- Work at any SANNEXUS-networked hospital in those states without restating your career
The Multi-State Physician Playbook
If you're a Florida-licensed physician who wants to expand into multi-state locum work, here is the efficient path:
Step 1: Verify your Florida license is current and in good standing. Check the Florida Board of Medicine online portal.
Step 2: Establish IMLC eligibility. You need an active, unrestricted license in your SPL state with no board actions. Most practicing physicians qualify.
Step 3: Apply for IMLC licenses in your target states. Priority states for SANNEXUS physicians include Georgia, North Carolina, Texas, and Tennessee — active IMLC members with physician demand.
Step 4: Create your SANNEXUS credentialing passport. Upload your documents once. Our AI-powered verification engine does primary source verification in real time, not in weeks.
Step 5: Browse available shifts. Our marketplace shows open physician assignments at SANNEXUS-networked hospitals across IMLC states. Filter by specialty, state, date, and rate.
The traditional timeline from "I want to work multi-state" to first paid shift: 4–8 months. The SANNEXUS timeline: 2–4 weeks (limited by IMLC processing, not by hospital credentialing).
The Bottom Line
Multi-state physician work is a real and growing opportunity. The credentialing infrastructure hasn't kept pace with physician mobility — until now. SANNEXUS exists to make your credentials as portable as your medical degree.