North Carolina Optometry Licensing Without Endorsement

The North Carolina State Board of Examiners in Optometry states its position in bold on its application page: "To practice in North Carolina you must take and pass our licensing exam, we do not have a reciprocity/endorsement policy." That applies to an optometrist with twenty years of practice as much as to a new graduate. Everyone sits the board's clinical-practicum examination, held twice a year, after passing the required National Board of Examiners in Optometry (NBEO) exams including the Injections Skill Exam (ISE). The board's exam application fee is $1,000.

The only exception is for military optometrists and military spouses under G.S. 93B-15.1, covered below. For everyone else, North Carolina is a calendar exercise, and the deadlines are earlier than people expect.

What does North Carolina require of every applicant?

The board's applicant information page, citing G.S. 90-118, says an applicant must show that they:

• are at least 18 and of good moral character;
• graduated from an accredited optometric institution approved by the board (21 NCAC 42B .0101);
• attained the required performance on the NBEO exams;
• filed a complete application form (BEO-1) with the fee; and
• passed the board's clinical-practicum examination.

The documentation includes the $1,000 fee under G.S. 90-123, a passport-size photograph, official optometry transcripts showing the date the degree was conferred, NBEO results, a birth certificate (a photocopy is accepted) and license verifications from every jurisdiction where you are currently licensed, sent directly to the board. The board also lists required courses that applicants complete online through its intranet.

Which NBEO exams does North Carolina want?

The board's NBEO page, updated December 23, 2024, lists:

• Passing scores on Parts I, II and III. For Part III PEPS, a passing score is required on each section, Skills and Patient Encounters, "even if you have an overall passing score." A candidate who failed a section but passed overall needs a letter from the board to NBEO to arrange the retake.
• A passing score on TMOD.
• A passing score on the ISE.

Earlier graduates must have passed every NBEO part offered when they tested, including TMOD if it was offered with Part II, and must also pass the ISE. For many experienced ODs, the ISE is the missing piece, and it has to be scheduled with NBEO before the board's deadline. NBEO lists the ISE at $350 for exams from August 2026. See ISE and LSPE: states that ask for the injection and laser exams and what each state asks to see from NBEO.

When are the 2027 and 2028 exams and deadlines?

From the board's examinations page:

• February 18 to 21, 2027. Application deadline December 21, 2026; completed application deadline January 19, 2027.
• August 20 to 23, 2027. Application deadline June 21, 2027; completed application deadline July 21, 2027.
• February 17 to 20, 2028. Application deadline December 20, 2027; completed application deadline January 18, 2028.
• August 18 to 21, 2028. Application deadline June 19, 2028; completed application deadline July 19, 2028.

The pattern is fixed: the application is due 60 days before the exam and the file must be complete 30 days before. To have NBEO results back for the second deadline, the board says you must have taken the NBEO exam in November for a February sitting and in May for an August sitting. The winter exam also has a condition: if fewer than ten eligible applicants are registered at the application deadline, those applicants are deferred to the next regular exam. Plan as if February might move to August. The board adds that dates may expand or contract with the number of applications.

Do you get the $1,000 back if plans change?

The board's rules on the application page are strict:

• An application still incomplete at the completion deadline is ineligible for that exam. It is refunded, or at your written request it can be held one time only for the next regular exam.
• Withdrawing before the completion deadline refunds the fee minus a $100 processing fee. Withdrawing after it refunds nothing.
• Not appearing at your scheduled time forfeits the fee and voids the application.
• An applicant who withdraws because of accident, illness or other good cause can, with proper certification, ask to carry the application forward once to the next exam.

Is there any path without the practicum exam?

Only for the military. Under G.S. 93B-15.1 and 21 NCAC 42B .0114, a military optometrist or military spouse optometrist may be licensed without the clinical-practicum exam. Both must show active practice for at least two of the past five years and meet the other general requirements. A military optometrist must show clinical education, training and experience substantially equal to that of practicum-licensed optometrists. A military spouse must hold an active license from a jurisdiction with equivalent requirements and show competence through an oral interview or another method the board sets. Applicants under this path apply for a specific exam date, and if they are not approved under the military rule, they may sit that exam without paying a further fee. There is no fee for military applicants.

Can you see North Carolina patients by telemedicine from out of state?

Only with a North Carolina license, and the board adds an office-licensing requirement. Its telemedicine position statement says "The practice of optometry occurs where the patient is located; therefore any OD who treats a patient located in NC must be licensed in NC." The board's licensee FAQ goes further: the practice of optometry occurs at both the optometrist's and the patient's location. An OD providing telehealth from home must license that location as a main or branch office, and an OD outside North Carolina seeing North Carolina patients must be licensed in North Carolina and maintain a main or branch office license where they are primarily located while seeing patients.

The position statement also sets standards a remote service has to design around. It says the standard of care does not permit an exam "consisting solely of objective refractive data or information generated by an automated testing device such as an autorefractor," and that a prescription based solely on a written or online questionnaire does not meet the standard. It asks for signed patient consent on the board's telemedicine form and a head shot of the doctor attached to the displayed license so the patient can match it to the person on screen. Before taking on North Carolina patients remotely, read tele-optometry: which state licenses you need.

Once licensed, what does North Carolina expect each year?

North Carolina CE runs on the calendar year. The board's current policy requires 25 hours annually, at least 20 of them "Certified" credit on listed medical subjects, at least 10 hours synchronous in person, and at most 5 hours of general credit, which includes asynchronous and practice management courses. Courses must be COPE accredited, or accredited by ACCME or another recognized health care accrediting body, and COPE courses post automatically from OE TRACKER. A licensee who misses a year's hours may be required to complete five extra hours under 21 NCAC 42B .0303. Each branch office needs its own duplicate license displayed there. And if you will work in North Carolina before your license issues, in any role other than a technician, the board requires an intern permit.

Where does a licensing service fit in a North Carolina move?

North Carolina is an Exam or Interview State License Application, which is $799. We build your timeline back from the 60-day and 30-day deadlines, check your NBEO record section by section and flag a missing ISE in time to schedule it, request verifications from every jurisdiction where you are licensed, gather the birth certificate, photo and transcripts, and track the file to the completed-application deadline. You complete and sign the BEO-1, take the required online courses, pay the board and sit the practicum. We never take an exam for anyone. If you are deciding between North Carolina and a state that offers endorsement, the $149 readiness review lays out both. See the North Carolina licensing page and states that require a state exam or a board interview.