In the Washington state (where Monica practices), the laws are quite stringent, requiring an educational background in Acupuncture Science, Western Science, and extensive clinical training. Persons with the necessary background must pass an exam given by the National Commission for the Certification of Acupuncturists before they are authorized to practice as Licensed Acupunturists. In 1995 the Washington State Legislature passed a bill authorizing the licensing of Professional Acupunturists. Other states vary widely in their requirements for practitioners; see Acupunture Laws by State.