NP / RN / PA Aesthetic Practice FAQ
What licenses does a medspa need?
A medspa needs: (1) state business license and entity registration, (2) practitioner licenses (APRN for NPs, MD/DO for physicians, RN for nurses), (3) DEA registration if prescribing Schedule II, (4) state-specific aesthetic-practice or medical-spa regulation compliance, and (5) building/health-department permits depending on jurisdiction.
The license stack at the practice level:
1. Business entity registration. PLLC, PC, LLC, or MSO/PC depending on state and structure. Filed with the Secretary of State.
2. State business license. Issued by the state (and often city or county) where the practice operates.
3. EIN (federal). Required for business bank account and tax filing.
4. Sales tax permit. Required in states that tax retail aesthetic products or services.
5. DEA registration. Required for the prescribing clinician if Schedule II medications will be prescribed. Aesthetic-only practices that only prescribe neuromodulators, dermal fillers, and fat-dissolving injectables do not strictly require DEA (those are not Schedule II), but most aesthetic practices register anyway for flexibility.
The license stack at the clinician level:
6. State APRN license (for NPs). Issued by state board of nursing.
7. State RN license (for RNs).
8. State medical license (for MD/DO medical directors).
9. National Provider Identifier (NPI). Federal requirement; free to obtain.
10. State controlled substance registration (separate from federal DEA in some states like Texas, Massachusetts, New York).
11. Professional liability (malpractice) insurance. Not a license but required to operate safely.
State-specific medical spa regulation:
A growing number of states have enacted or are considering "medical spa" specific regulation. These typically require: - Registration of the medspa as a medical facility (separate from general business registration) - Disclosure of the medical director or supervising physician - Specific signage requirements (e.g., medical director name and license number displayed) - Protocols for good-faith exam, chart maintenance, and adverse event reporting
States with medspa-specific statutory frameworks (as of 2026): - Arizona — Arizona Board of Cosmetology defers to Board of Nursing for medical aesthetic services - Florida — Office-based surgery rules apply if certain procedures are performed - Texas — Medical Spa Bill 1521 (regulatory framework defining medical spa) - New Jersey — Office of the Attorney General medspa guidance - Illinois — Medical Spa Compliance Act (limited) - California — Cosmetic Medical Board Advisories
This list is incomplete and changes frequently. Confirm with state counsel before launch.
Local permits:
12. Building permit (if doing build-out). Required by city or county.
13. Health department permit. Some jurisdictions require medical facilities to be permitted separately from general business.
14. Fire department / occupancy permit. Standard for any commercial space.
15. ADA compliance. Federal requirement for any public accommodation; your build-out must comply.
16. OSHA workplace safety registration if employing any staff.
What the assessment at /find-your-starting-point returns: a state-specific license-stack checklist for your scenario, ordered by which item to tackle first.