In 1903 North Carolina became the first state to have a Board of Nursing that would set standards for nursing education and practice. Prior to that doctors determined nursing practices. The Board had two medical doctors and three nurses who were all appointed. It was not until 1981 that a state law was passed that allowed Board members to be elected by nurses with only one appointed member. This meant that nursing controlled its own practice just like other professions. Today, the Board consists of representatives from all areas of nursing practice. In 1965 nurses were mandated to have a license which meant that nursing became a regulated practice that ensured the safety of the public. In 1999 the state of NC decided that only a person holding either a RN or LPN license could use the title of nurse.