How long does a Missouri medical license take?

At least six weeks of processing once your application and fee reach the board’s queue, and at least four weeks of review once every document is in, by the board’s published minimums, which are not averages. On reciprocity, Missouri law gives the board six months from receipt to decide whether to waive its exam, education, and experience requirements, and MACHS says fingerprint results usually take 7 to 10 business days. On the compact route, IMLCC’s Year 9 averages were 38 days from application to a Letter of Qualification, then 22 days from qualification to issued licenses.

How much does a Missouri medical license cost?

$149 in published fees by reciprocity, MD or DO: the $102 license fee and the $47 Missouri and FBI fingerprint check on MACHS’s fee schedule. By examination it costs $219 for an MD and $214 for a DO, with a $70 USMLE or $65 COMLEX transcript, and the compact route costs $802: $700 to the IMLCC plus $102 for Missouri. The local charge for rolling a fingerprint card out of state, any verification fees, and the $30 BNDD and $888 DEA registrations come on top.

Is Missouri in the IMLC?

Yes. Missouri enacted the Interstate Medical Licensure Compact in 2023, effective August 28, 2023, issues licenses through it, and can be your state of principal license. In IMLCC’s Year 9, April 2025 to March 2026, the board approved 273 Letters of Qualification and issued 835 licenses through the compact. Compact fees come to $802: $700 to the IMLCC plus $102 for Missouri.

Can I get a Missouri license by reciprocity?

Yes, if you have held a valid, current license in another state, a US territory, or DC for at least a year, met its education and exam requirements to get it, and are in good standing, with no complaint or investigation pending. The board then waives its exam, education, and experience requirements, so you send no scores, diploma, transcripts, or training certificates, only a verification of that license. Missouri law gives the board six months from receipt to decide, and the fees are the same $102 and $47 as on any direct application.

Do MDs and DOs apply differently in Missouri?

Barely. One board licenses both, through the same application and the same $102 fee, and the IMLCC lists a single Missouri fee. By examination, DOs send COMLEX-USA scores from NBOME, at $65, instead of USMLE scores from FSMB, at $70; on reciprocity neither sends scores.

Do I need a Missouri license to treat Missouri patients by telehealth?

Yes, with narrow exceptions. Missouri law requires health care providers to be fully licensed in Missouri to treat patients there by telehealth, and Missouri has no out-of-state telehealth registration; the exceptions are informal, unpaid consultation on an irregular basis outside a contract, free care in an emergency or disaster, and episodic consultation at a Missouri physician’s request. A license issued by reciprocity carries the same telehealth rights as any other, and prescribing controlled substances also takes a BNDD registration.

Can an out-of-state physician get a Missouri controlled substance registration?

Not on the verified date: BNDD’s page said Missouri does not issue controlled substance registrations to out-of-state practitioners and is not processing their applications while the matter is under review. Missouri law requires the registration before you prescribe a controlled substance in Missouri; BNDD issues it for a Missouri practice location, at $30 for up to 12 months, and it comes before a Missouri DEA registration.

Does Missouri require fingerprints or a jurisprudence exam?

Fingerprints yes, a jurisprudence exam no. Every direct applicant completes a Missouri and FBI fingerprint check, $47 on MACHS’s published fee schedule, with electronic prints at a state vendor site in Missouri or a card rolled out of state, for which MACHS lists no separate amount; MACHS says results usually take 7 to 10 business days. On the compact route, your state of principal license runs the check.

Is FCVS required in Missouri?

No. The board accepts an FCVS profile, which can carry your diploma, transcripts, exam scores, training certificate, and name change documents, but neither its application nor its rules require one. A first profile costs $395, transcripts included, which puts the examination route at $544; on reciprocity those records are not needed.

What does staying licensed in Missouri involve?

Renewal every year by January 31, for $147; 50 hours of CME every two years, at least 1 on the health benefits of nutrition; a BNDD registration, $30 for up to 12 months, to prescribe controlled substances; and a separate $888 DEA registration for Missouri. Missouri law sets no duty to check its PDMP before prescribing.

Missouri physician license: fees, timeline, requirements, and common delays

Missouri licenses MD and DO physicians through one board, the State Board of Registration for the Healing Arts, directly or through the IMLC, and can be your state of principal license. After a year of licensure elsewhere, reciprocity costs $149 in published fees: the $102 license fee and a $47 Missouri and FBI fingerprint check. By examination, with the exam transcript, an MD pays $219 and a DO $214; compact fees are $700 to the IMLCC plus $102. The board publishes minimums: 6 weeks of processing, and 4 weeks of review once a file is complete. The friction is prescribing: on the verified date, Missouri’s Bureau of Narcotics and Dangerous Drugs said it was not processing controlled substance registration applications from out-of-state practitioners.

Missouri at a glance.

License: Permanent physician and surgeon license (MD or DO), renewed every year
MD and DO: One board, one application and one fee schedule for both
IMLC: Member state, issuing licenses. Missouri can be the SPL; $700 IMLCC fee plus $102 for Missouri
FCVS: Accepted, not required
Uniform Application: Not used
Fingerprints: Required on direct routes: Missouri and FBI checks, by electronic prints in Missouri or a mailed fingerprint card
Jurisprudence exam: None
Interview: Not routine; the board can ask you to appear before it
Board fee: $102 license fee, nonrefundable, the same on every direct route
Renewal: Every year, $147; every license expires January 31
CME: 50 hours every two years, at least 1 on the health benefits of nutrition

Which route fits.

MDs and DOs file the same application, for the same $102 fee, with one board. A physician licensed in another state has three ways to a full Missouri license: reciprocity after a year of licensure, the examination route, and the IMLC. Missouri has no out-of-state telehealth registration: its law requires a full Missouri license to treat patients in Missouri by telehealth, except informal, unpaid consultation on an irregular basis, free care in an emergency or disaster, and episodic consultation at a Missouri physician’s request.

Licensure by reciprocity.

Who it fits: Physicians who have held a valid, current license in another state, a US territory, or DC for at least a year and met that jurisdiction’s education and exam requirements to get it. The record must be free of a revoked license, a pending complaint or investigation, current discipline, and a disqualifying criminal record.
The trade-off: The smallest Missouri file and the lowest published fees, $149: the $102 license fee and the $47 fingerprint check. The board waives its exam, education, and experience requirements, so your scores, diploma, transcripts, and training certificates stay out of the file, and the one verification the application asks for comes from the board in the state you name. Missouri law gives the board six months from receipt to decide the waiver, and since August 28, 2026, Missouri’s general reciprocity law has given a license issued under it the same telehealth rights as any other.

Licensing board: Missouri State Board of Registration for the Healing Arts.

Licensure by examination.

Who it fits: Physicians licensed elsewhere for less than a year, or not yet licensed, such as those just out of training. It is the same application and the same $102 fee, filed on your USMLE or COMLEX-USA record instead of reciprocity’s waiver.
The trade-off: The full file: a diploma and transcripts from an accredited school or a valid ECFMG certificate, a postgraduate training certificate, official exam scores, and the fingerprint check, which brings published fees to $219 for an MD and $214 for a DO. Every board in your license history verifies its license, and Missouri sets no deadline for the board to decide.

The IMLC.

Who it fits: Physicians whose state of principal license is another member state and who meet the compact’s terms, which include current specialty certification. Missouri can also be your state of principal license, to add other member states; the board says its verification for that may take more than 45 days.
The trade-off: It costs more: $700 to the IMLCC plus $102 for Missouri, $802, none of it refundable, against $149 by reciprocity; adding Missouri to a Letter of Qualification still within its 365 days costs $202. Your state of principal license runs the background check, the Missouri license renews through the IMLCC, and it ends if you stop holding your principal license for a non-disciplinary reason without naming a new state.

What it costs.

MD or DO license by reciprocity
License fee	$102
Missouri and FBI fingerprint check, the fee MACHS publishes	$47
All-in	$149
Our service fee	Quoted with your plan

MD license by examination
License fee	$102
Missouri and FBI fingerprint check, the fee MACHS publishes	$47
USMLE transcript (FSMB)	$70
All-in	$219
Our service fee	Quoted with your plan

DO license by examination
License fee	$102
Missouri and FBI fingerprint check, the fee MACHS publishes	$47
COMLEX-USA transcript (NBOME)	$65
All-in	$214
Our service fee	Quoted with your plan

MD or DO license through the IMLC
IMLCC fee	$700
Missouri license fee, from the IMLCC fee table	$102
All-in	$802
Our service fee	Quoted with your plan

The $102 license fee goes to the board, the same for an MD or a DO on every direct route, and the board’s fee rule makes all fees nonrefundable. The $47 is the total of the fee schedule that MACHS, the state’s fingerprint background check service, publishes for a Missouri and FBI check: $20 for the Missouri search, $15 for the FBI search, and a $12 vendor fee. It is the only fingerprint fee a state source publishes, and MACHS lists no separate amount for a card mailed from out of state. Transcript fees go to FSMB or NBOME. On the IMLC route, the $700 and the $102 both go to the IMLCC, which calls every compact fee non-refundable; adding Missouri to a Letter of Qualification still within its 365 days costs a $100 handling fee plus the $102. Missouri waives licensing fees for two years for military families and low-income individuals whose waiver it approves.

Left out of every total: the charge for rolling a fingerprint card outside Missouri, set by whoever rolls it, and any difference in card-scan processing fees, which no state source publishes; the verification of the license you name for reciprocity, free where that board offers one to download and otherwise at its fee; verifications from other boards in your license history, at each one’s fee, only if the Missouri board cannot verify them itself; a notary for the oath on a paper application; FCVS, which is optional, $395 for a first profile with transcripts included, or $544 in all on the examination route; for international graduates using FCVS, ECFMG’s one-time $75 medical education verification and its $70 certification status report; and, if you prescribe controlled substances, the $30 BNDD registration and the $888 DEA registration. On the IMLC route, fingerprints and verifications run through your state of principal license, at its fees.

Fees change; verified November 11, 2026.

How long it takes.

At least 6 weeksBoard processing, once the application and fee are in its queueThe board’s published minimum, not an average, counted from when it has the application and license fee and the file is placed in its queue; the page that states it covers every profession the board licenses.Board-published
At least 4 weeksBoard review, once every document is inThe board’s published minimum for reviewing an application after it has received all required documents; it approves no application until the entire file is complete.Board-published
6 monthsDecision on a reciprocity waiverMissouri law requires the board to decide, within six months of receiving a reciprocity application, whether to waive its exam, education, and experience requirements; the clock ends at that decision, not at issuance.Statutory deadline
38 daysIMLC application to Letter of QualificationIMLCC’s Year 9 average across the compact, April 2025 to March 2026; 55% received the letter in 30 days or less.IMLCC average
22 daysIMLC qualification to licenses issuedIMLCC’s Year 9 average for the next stage, from qualification to the requested state licenses; 47% received them in 7 days or less. The two stages are separate averages, not a total.IMLCC average

Missouri sets no deadline for deciding an application by examination, and the board’s two published minimums, not averages, run from different points: the queue and the complete file. MACHS says fingerprint results usually reach the agency that requested them within 7 to 10 business days of fingerprinting. Missouri law gives the board 30 days to waive its exam, education, and experience requirements and issue the license to a qualifying military spouse, and its general reciprocity law gives the spouse of a Missouri law enforcement officer the same clock. If Missouri is your state of principal license, the board says its verification for the compact may take more than 45 days. No board guarantees a date.

What the file involves.

A reciprocity file, the usual route for a physician licensed elsewhere at least a year, moves between 3 core parties and holds 6 core document types: the application with its oath, the fee, the fingerprint check, a verification of the license you name, a photograph, and proof of US citizenship, permanent residence, or lawful presence. Your school, training programs, exam bodies, and employers verify nothing on this route, and other boards in your history do only if the Missouri board cannot verify a license itself. A file by examination involves 6 core parties and 9 core document types: your school or ECFMG, each training program, FSMB or NBOME, every board in your license history, the fingerprint services, and the board; FCVS, which is optional, can carry the school, training, and exam records. On the IMLC route, the Missouri file involves 3 parties: the IMLCC, your state of principal license, and the board.

The Missouri State Board of Registration for the Healing ArtsMakes its own inquiries into your background, can obtain an NPDB or FSMB report on you, verifies the rest of your license history where it can, and issues the license.
A fingerprint service, IDEMIA, the Missouri State Highway Patrol, and the FBITake your prints, electronically at a state vendor site in Missouri or on a card rolled out of state, which IDEMIA processes, and run the Missouri and national criminal history checks for the board.
The boards that have licensed youOn reciprocity, the board in the state you name verifies that license, and others only if the Missouri board cannot verify theirs; by examination, every board in your history verifies.
Your medical school, or ECFMG (examination route)Documents your degree: a diploma and official transcripts from an LCME- or COCA-accredited school, or for international graduates a valid ECFMG certificate.
Each postgraduate training program (examination route)Certifies the postgraduate training you completed.
FSMB or NBOME (examination route)Sends your official USMLE or COMLEX-USA scores; the board does not accept a personal copy.

A year of licensure, for reciprocity: At least one year holding a valid, current license in another state, a US territory, or DC, still current on the day the board receives the application. With less than a year, you apply by examination, where Missouri’s training and exam rules apply in full.
Postgraduate training, by examination: One year in an ACGME- or AOA-accredited program for graduates of LCME- or AOA-accredited schools, under the board’s rule. For ECFMG certificate holders, Missouri law has required two years since August 28, 2026.
Exam window and attempts, by examination: Steps one to three of the USMLE or COMLEX-USA within seven years, with no more than three attempts on any step. The board can waive this for a physician licensed in another state, DC, or Canada who passed a licensing exam in a US state, territory, or DC and has never had a license disciplined, and may then limit the license to the board specialty.
Time out of practice: If you have not practiced clinical medicine or held a teaching or faculty position for any two of the three years before applying, Missouri law lets the board require another exam, CME, or more training before a permanent license. Its rules name SPEX, COMVEX, and specialty board exams, and count the equivalent of 400 hours a year as active practice.
Board certification: Not required: Missouri law bars requiring specialty certification or maintenance of certification to practice medicine. Certification counts in some of the board’s waivers and satisfies the CME hours for a reporting period in which you earn or renew it, and the IMLC requires it.

We run the Missouri file.

We do

Check whether reciprocity, the examination route, or the IMLC fits your licenses before any fee is paid.
Prepare the Missouri application and check every answer against the 2026 statute and the board’s current requirements before it goes in.
Request and chase every verification your route needs: the license you name for reciprocity, or on the examination route your school, training, and score records.
Coordinate your Missouri and FBI fingerprint check and track it until the results reach the board.
Answer every board request and follow the file until the license issues.

You do

Share your credentials and license history once, in our secure portal.
Approve your application answers and sign the oath, before a notary if the application goes in on paper.
Have your fingerprints taken, at a state vendor site in Missouri or on a card rolled near you.
Appear before the board if it asks.

Get My Licensing Plan

Staying licensed.

Renewal cycle: Every year: every Missouri physician license expires on January 31, and renewal costs $147. Missouri law gives a new licensee registration through the next January 31 with no registration fee. The board emails renewal information by November 1; a renewal postmarked February 1 or later adds the $25 delinquent fee, and a license left unrenewed for two consecutive renewal periods is void. A license issued through the compact renews through the IMLCC.
CME: 50 hours every two-year reporting period, which runs from January 1 of an even-numbered year to December 31 of the next year; the current one ends December 31, 2027. At least 1 of the 50 hours must cover the health benefits of nutrition, required since June 30, 2026, and the board says that hour can be part of a course in your specialty. Credit counts if it is AMA Category 1, AOA Category 1-A or 2-A, or AAFP Prescribed; 40 hours, all AMA Category 1 or AOA Category 1-A with a post-test for each, also meet the requirement, and specialty board certification or recertification in the period satisfies it. The rule exempts the first reporting period only for physicians who have never held a permanent license in Missouri or another state.
State controlled-substance registration: Yes: a registration from the Bureau of Narcotics and Dangerous Drugs (BNDD), part of the Department of Health and Senior Services, required before you prescribe a controlled substance in Missouri and before a Missouri DEA registration. It costs $30, lasts up to 12 months, and is issued for a Missouri practice location, one for each principal place of practice. On the verified date, BNDD’s page said Missouri does not issue controlled substance registrations to out-of-state practitioners and that it is not processing their applications while the matter is under review; for a Missouri location, it asks applicants to allow 3 to 5 business days.
Prescription monitoring: Missouri’s statewide PDMP, run by a joint oversight task force in the Office of Administration, collects Schedule II to IV dispensations. Registration is optional for prescribers, and Missouri law sets no duty to check the PDMP before prescribing, though the PDMP notes that the federal SUPPORT Act requires a check before prescribing a Schedule II to IV controlled substance to a MO HealthNet participant. Access is limited to providers licensed in Missouri, and the program shares no data with other states.
DEA registration: $888 for three years, with a separate registration for Missouri, after the BNDD registration.
E-prescribing: Required for Schedule II, III, and IV controlled substances since January 1, 2021, with 11 exceptions, among them prescriptions to be dispensed by a pharmacy outside Missouri and annual waivers.
Opioid prescribing: An initial opioid prescription for acute pain is limited to a seven-day supply, with documented exceptions.
Telemedicine prescribing: Missouri law requires a valid physician-patient relationship, as its telehealth law defines it, before you prescribe through telemedicine; both provisions were amended effective August 28, 2026.
Reporting duties: Tell the board of an office address or name change within 15 days. A Missouri tax delinquency or failure to file can bring suspension of your license within 90 days of the Department of Revenue’s notice.

Renewals, CME tracking, and DEA registrations are managed where included in your plan: physician licensing at NP Licensing.

Frequently asked questions

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Also licensing in these states?

Illinois One agency licenses MDs and DOs, by endorsement or through the IMLC.
Tennessee Separate boards for MDs and DOs, each licensing directly or through the IMLC, plus locum tenens licenses for physicians living outside Tennessee and a telemedicine license for DOs.
California Two boards and no IMLC route: every California license is a direct application.
Texas One board licenses MDs and DOs, by direct application or through the IMLC.
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