Section 197A. An individual who holds a license as a hearing instrument specialist or the equivalent thereof as determined by the board from a state which is deemed by the board to have substantially equivalent or higher licensure requirements than those of the commonwealth may be licensed as a hearing instrument specialist without satisfying the requirements of clause (4) of subsection (f) of section 197. The word ”state”, as used in this section, shall include a state or territory of the United States, the District of Columbia, the commonwealth of Puerto Rico or a foreign country, state or province.