Occupational Therapy is a registered and/or licensed profession in all 50 states. To become licensed to practice as an occupational therapist in most states (including Illinois), a student must graduate from an ACOTE-accredited or approved educational program and pass the national certification examination for the occupational therapist administered by NBCOT. Most states (including Illinois) require status as an occupational therapist registered (OTR) to become a licensed occupational therapist (OTR/L). Most states require licensure in order to practice. A prior felony conviction may affect a graduate's ability to sit for the NBCOT Certification Exam or attain state licensure.