b'2021 CERTIFICATION ACTIVITIESFIGURE 3: States Use of NCCAOMAll states that regulate acupuncture (except Certification or Exams forfor California) require at the least passage of AcupunctureLicensure AND the Foundations of Oriental Medicine (FOM) Number of NCCAOM Active Diplomatesand Acupuncture with Point Location (ACPL) per State as of December 31, 2021 examinations for licensure . Forty-six states plus the District of Columbia recognize NCCAOM certification or exams for licensure (see Figure3) and 11 states require passage of the Chinese Herbology (CH) examination for licensure . VT-104*WA-1,002 NH-117MA-705**CT-188 MEMT-83 ND-11 RI-63 159OR-1,305 MN VTID-91 618 NY NHSD-17 WI-279 1,863 MAWY-26 MI-227 CT RIIA-74 PA-411 NJNV-74 NE-26 OH**UT-113 IL IN 268 MD DE DCCA CO-1,175 660 81 WV2,473 14 VA-433KS-52 MO-112 KY-68 NJ-814**DE-26TN-162 NC-471 MD-382AZ-446 OK-28 DC-45NM-420 AR-37 SC-131MS-7 AL-22 GA-267TX-928 LA47AK-94FL1,231HI-185l States that use NCCAOM Examination(s) * Acupuncture certification is not required . However, passage of the Chinese Herbologyl States that require NCCAOM Certification exam is required to practice herbs .l States with no Acupuncture Practice Act ** Chinese Herbology or Oriental Medicine certification is required to practice herbs .l California Licensing ExaminationNCCAOM 2021 ANNUAL REPORT 17 DEDICATION IN THE FACE OF DIFFICULTY'