May not have medical license in time to meet h1b premium processing deadline

[santai]

hi,
My wife is applying for a H1b visa to start her medical fellowship training in New York State. She has Canadian residency training, citizenship, and medical degree.
She is applying for a H1b visa. Her institution is helping her with this and were previously not really rushing it as we thought that she had a lot of time.
With premium processing being no longer valid from April 3, this is now an issue in terms of getting it in on time.
She still has not applied for her medical license. She should meet all of the requirements and has the USMLE 1-3 - but it will be challenging to get this state license issued before the H1b application is due (end of the month).
Is there any way to get an extension or any way around having a valid state medical license by the date of the h1b visa filing? Will her application be rejected without her state license - can we still keep the premium processing open while awaiting the license?

Thank you

[santai]

bump

[inadmissible]

Her institution is applying the visa... do their staff/attorneys have any good ideas?
Perhaps they can file the H app as is and receive a Request for Evidence or Notice of Intent to Deny, and then respond with evidence of the medical license within the RFE/NOID window? Perhaps they can file a TN app instead when she is properly qualified, and not worry about the H lottery?