Armed Forces Optometric Society

Licensure by Endorsement Background



Michael Feeser OD, FAAO


In 1995, the American Optometric Association House of Delegates adopted resolution #1915, which supported the process of licensure by endorsement. In 1999, the AOA HOD adopted resolution #1 of 1999, which called for the repeal of time limits for National Board scores for licensure by endorsement.  Since the states do not require their own optometrists to retake the National Board tests, why would they require it for established practitioners from out of their state?  So, how far have we come since these resolutions were passed? What is licensure by endorsement and how does it affect you as a federal service optometrist? First, we need to understand what licensure by endorsement is and what it is not.


ENDORSEMENT--endorsement is the process whereby the State Board of Optometry has been given authority by the state legislature to assess the equivalency of an individual applicants credentials to that state’s own licensure standards, regardless of Interstate contractual agreement.


RECIPROCITY--a relationship between 2 or more state boards of optometry that determines that there licensure standards are equivalent, or nearly equivalent, and enter into a contractual agreement granting licenses to applicants from one another state. In actuality, there are no true reciprocal agreements between any 2 or more state boards of optometry.


To be listed as an endorsement state, optometry laws :


1. MUST NOT require a candidate for licensure by endorsement to have taken and passed a SPECIFIC entry level written, practical or clinical examination to obtain their original license. If a law does require a specific examination, the optometry board must have the authority to waive that requirement or accept another examination passed by the candidate in lieu of this specified examination.

2. MUST NOT require candidates for licensure by endorsement take state administered written, practical, clinical, pharmacology, or oral examination that may still be given by a state optometry board for new graduate candidates for licensure. A state administered law exam is acceptable.

3. MUST NOT require that reciprocal privileges be granted by the applicant‘s state of current licensure.

4. SHOULD REQUIRE that licensure requirements in the state where an optometrist received his/her first license included the passage of AN examination.

5. SHOULD REQUIRE that candidates hold prescriptive authority at the highest level possible in their state of current licensure and have completed appropriate equivalent education in treatment of eye disease, including passage of a test on pharmacology.

6. SHOULD REQUIRE that candidates apply for a license that grants the highest level of prescriptive authority possible.

7. SHOULD REQUIRE candidates to take a state law exam, if one is given.

8. SHOULD REQUIRE candidates for licensure by endorsement prove that they were licensed "in good standing" in every state where the applicant holds or has held a license, including compliance with continuing education requirements.

9. SHOULD REQUIRE that applicants for licensure by endorsement have been in active practice for a certain number of years as determined by the board immediately prior to application. "Active practice" is defined to include military service or employment as the faculty of school or college of optometry.

10.MAY REQUIRE on an individual basis the passage of a written, practical, or clinical examination ONLY IF the competency of the candidate for licensure by endorsement is in question.

11.MAY REQUIRE on an individual basis completion of additional continuing education or course work IF the competency of the candidate for licensure by endorsement is in question.


One of the basic cornerstones of endorsement is the possibility for a competent practitioner to obtain a license in another state without automatically being required to retake exams designed to evaluate entry level skills. On this point, it is easy to identify those states that very clearly violate this requirement by requiring all practitioners, new, and established, to take clinical examinations:


ALABAMA, ARKANSAS, FLORIDA, KANSAS, LOUISIANA, MISSISSIPPI, NEW MEXICO, NORTH CAROLINA, OKLAHOMA, WEST VIRGINIA, WYOMING. The state of Florida requires established practitioners to retake NATIONAL BOARDS PART 1, PART 2, AND PART 3, if it has been more than 5 years since the tests were taken.  West Virginia requires an oral clinical exam which also violates the spirit of licensure by endorsement.


The states that meet all requirements for licensure by endorsement are the following:




Obviously, we have a long way to go.  Given that some states, like the Sunshine State, have to consider the possibility of being flooded with part time retirees from all over the country, it is unlikely that we will reach 100% on this issue.  Based on the direction of the House of Delegates, it is official American Optometric Association (AOA) policy to support the licensure by endorsement process.



Licensure by Endorsement Documents

Fact Sheet AOA 1995
House of Delegates Resolution -- 1995
AOA HOD Resolution for Repeal of NB Time Limites - 1999
AFOS Newsletter July 2001
ARBO draft letter for CELMO -- 2003
AOA Licensure by Endorsement Arguments -- 2004Guidelines for Laws -- AOA -- 2005
States Eligible for Licensure by Endorsement -- 2010

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