In 1996, the Occupational Health Law and Policy Section of the American College of Occupational and Environmental Medicine (ACOEM) was asked to undertake a study of state licensing regulations after the prosecution of an ACOEM member for practicing medicine without a license. In response to that member's experience, the ACOEM House of Delegates passed a resolution asking the College to lobby individual states for an exclusion to their licensing acts for occupational and environmental physicians. Recognizing the tremendous obstacles to this task, the ACOEM Board of Directors then referred the issue to the Occupational Health Law and Policy Section for further study and analysis. What follows is a report of that study, including the results of a survey mailed to the licensing authorities of the 50 US states and four US territories. The results of this study are not meant to offer advice to College members regarding compliance with specific state licensing regulations, nor does it define the official position of the states that responded. States that responded were careful to disclaim their responses as the official position of their states' agencies and were assured that the responses were provided for informational purposes only. The purpose of the survey was not to provide information for reference but simply to identify general trends and document the various positions that states may take on certain licensing issues.