Endorsement or NBEO Scores: Which Route Fits Your Move

When an optometrist licensed in one state applies in another, the board often offers more than one route. The two most common are an application on NBEO scores, the same route a new graduate takes, and endorsement, which leans on your existing license and practice history. Boards name them differently, and some states let you choose while others decide for you. Picking the wrong one costs time: a file built for endorsement can stall on a years-of-practice question that the NBEO route never asks.

What is the actual difference between the two routes?

An NBEO-score application asks whether you passed the national exams the state requires. Your license elsewhere matters for verifications and discipline history, but not as the basis of the license. Endorsement asks whether your current license, and the exam and practice behind it, meet the new state's standard. That usually brings in years of practice, a comparison of the other state's requirements, and sometimes a showing that the other state treats this state's licensees the same way.

Illinois puts the two side by side. "Acceptance of Examination" is for an applicant who "has taken a National Exam ... in any state" and "may or may not be licensed in another state." "Endorsement of License" is for an original license "issued in another state and that state's requirements were substantially equivalent to Illinois requirements at time license was issued." Both cost $500. The endorsement file adds a copy of the licensing acts and rules of the state of original licensure for the time you were licensed there.

When does a state decide the route for you?

More often than people expect. Four examples:

• Texas: everyone who passed all NBEO parts files the same Acceptance Application, $205, with no years of practice. The $305 License without Examination is only for optometrists licensed elsewhere before 1994 who could not take Part III, and it needs five of the last seven years in therapeutic practice or full-time teaching. Texas says plainly that it is "NOT for a person who has taken and failed Part III."
• New York: endorsement "applies only to those applicants who were licensed without having taken the NBEO," mostly pre-1969 graduates, and needs five years of practice in the last ten. Everyone else applies on NBEO scores.
• Oregon: optometrists who passed TMOD in 2002 or later must apply by examination, on NBEO scores plus the Oregon law exam, with no years of practice. Endorsement under ORS 683.220 is for earlier licensees and needs two continuous years of practice.
• Arizona: an optometrist who practiced at least four of the last five years in one jurisdiction with scope equal to or higher than Arizona's must apply by endorsement, which waives the written exam. Regular applicants need NBEO scores from the last 10 years.

Where do you get to choose?

• Minnesota: most applicants, licensed elsewhere or not, apply on NBEO Parts I, II, III and TMOD plus the Minnesota law exam. A separate paper endorsement application serves optometrists who practiced in another state for the three years before applying and passed written and practical exams there.
• Missouri: qualify by examination on NBEO scores, or by endorsement with at least three of the last five years in practice with pharmaceutical certification. Both routes need the Missouri law exam and fingerprints.
• Hawaii: any ACOE graduate with NBEO Parts I, II and III can apply; reciprocity is a separate route needing four of the last five years, a home state that grants Hawaii licensees like privileges, and equivalent education.
• Pennsylvania: the board may license without exam an applicant who passed all parts of NBEO, or one who practiced in another state for the four years immediately before applying.
• South Dakota: new applicants use the general application on a passed national board exam with no years of practice; the statute also allows endorsement after five consecutive years.
• Wisconsin: NBEO Parts I, II, III and TMOD plus the state law exam, or endorsement after five years of practice in another state.
• Indiana: apply by examination with NBEO Parts I, II, III and TMOD, or by reciprocity, where you bear the burden of proving the home state's requirements are equivalent.

Which route is usually lighter?

If you passed every part the state requires, and your scores fall inside any window the state sets, the NBEO route is usually the lighter file. It skips years-of-practice proof, employer letters and comparisons of another state's law, and most boards that offer it set no practice minimum. Michigan is a good illustration from the other direction: it licenses out-of-state optometrists by endorsement with no minimum years, but those licensed elsewhere under three years also send transcripts and NBEO scores, while those licensed three years or more do not.

Endorsement tends to be the better route in three situations:

1. You are missing an NBEO part. If you were licensed before Part III or TMOD existed, endorsement or a state's equivalent, such as Texas's License without Examination, may be the only route. See routes for optometrists licensed before Part III.
2. Your scores are outside a state's window. Kentucky's standard application wants NBEO parts passed within five years, and Arizona's regular route within 10. Both have endorsement routes for experienced optometrists.
3. The other route is impractical. Florida's exam route requires the Florida Practical taken with NBEO Part III, so experienced optometrists use MOBILE endorsement, which asks for two of the last four years in practice. See Florida licensing and the MOBILE route.

What can go wrong on the endorsement side?

Endorsement statutes carry conditions the NBEO route does not. Massachusetts requires an intent to reside and practice in Massachusetts, and a state that grants Massachusetts licensees a like privilege. Mississippi and Rhode Island bar anyone who failed their own exam. Kansas reciprocity requires that the other state grant Kansas licensees a like privilege, plus professional liability insurance and a Kansas law exam. Florida's MOBILE disqualifies anyone ever reported to the National Practitioner Data Bank, unless the report was removed on appeal or the conduct would not violate Florida law. If one of those conditions fails, the endorsement route closes even when your years are fine. Our guide to how states count years of practice covers the counting itself.

How different is the paperwork?

Illinois's application shows the gap item by item. On either route you submit the personal history form, an education form completed by your school's dean or registrar with the school seal, a certified NBEO score report sent directly to the Division, and, if you have ever been licensed, Form CT from your original and current states. Earlier graduates add training verification forms by graduation year. Endorsement adds a copy of the licensing acts and rules of your original state for the time you were licensed there, and the board evaluates your application by comparing your exam results in that state with the Illinois exam given the same year.

Texas's License without Examination goes further: each state where you were licensed completes a Texas form describing your initial and therapeutic licensure, the board approves the file at a scheduled meeting, and the complete file must arrive at least 30 days before that meeting. The Acceptance Application on NBEO scores needs none of that.

How should you decide?

Start with three facts: which NBEO parts you hold and when you passed them, every license you have held and its status, and your practice history by month for at least the last seven years. Then check each target state's routes on its state page, through the state license index, or on the out-of-state licensing hub. The Optometry Licensing Readiness Review ($149, credited in full toward a first application) does that comparison for every state you name and tells you which route to file. A license on NBEO scores or by endorsement is $699 per state either way; see pricing.