Chiropractic Certification and Licensure

Chiropractic Certification and Licensure

Chiropractic is a regulated healthcare profession in the United States--and has been for more than 100 years. Before being granted a license to practice, doctors of chiropractic (DCs) must meet stringent educational and competency standards.1   

Along with completing at least 90 hours of pre-professional college education and graduating from an accredited chiropractic college, DCs who wish to attain a license to practice in the U.S. must first pass rigorous national board exams to verify that they have the knowledge and skills necessary to effectively and safely treat patients.1 Individual state chiropractic boards, which approve and manage licensure, have additional requisites that must be met.

National Testing

The national board exam system for the chiropractic profession is managed by the National Board of Chiropractic Examiners (NBCE). NBCE develops, administers and scores standardized exams that assess chiropractic college graduates’ knowledge, higher-level cognitive abilities and problem-solving in various basic science and clinical science subjects. NBCE’s exam is divided into four parts: basic sciences (Part I), clinical sciences (Part II), clinical competency (Part III), and  practical skills (Part IV).

State Licensure

Each state has its own requirements for chiropractic licenses, based in part on the scope of practice determined by the state for DCs within its borders. In some states, chiropractors may provide a wide variety of treatments; in others, their services are more focused. In addition to meeting established educational requirements and passing national board exams, licensure in a state might include testing to verify a doctor’s knowledge of the state scope of practice, a background check, providing personal references, and proof of malpractice insurance.

Most states have their own chiropractic regulatory board that not only administers licensing for chiropractors but also takes action in cases where consumer complaints are reported. In some states where there is no chiropractic-specific board, this role is administered through a state medical board or a board that represents multiple healthcare professions.

Like their medical colleagues, chiropractors must renew their licenses on a regular basis. As a requirement for renewal, most states mandate that chiropractors take continuing education (CE) courses and earn a specific number of CE credits each year.

The Federation of Chiropractic Licensing Boards (FCLB) provides a forum in which state chiropractic licensing board members meet to address common areas of interest and concern with respect to chiropractic regulatory law. Among its activities, FCLB compiles and publishes regulatory board contact information (see list here) and summaries of the requirements to obtain and maintain licensed status in the United States and its territories, Canada, and Australia. FCLB also maintains a database of public actions taken with regard to individual chiropractic licenses, provides certification of chiropractic continuing education courses through its PACE program and provides a certification course for chiropractic assistants.



  1. Practice Analysis of Chiropractic 2015, National Board of Chiropractic Examiners, Accessed May 2019.