Scope of Practice11 min read · Published 2026-09-19

Who Can Inject Botox? Rules in 14 States

A state by state reading of who may inject neurotoxins and fillers, what supervision the board actually requires, and what each state does and does not put in writing. Every row is read from a statute or board rule listed in the sources at the end.

The short answer

Botulinum toxin is a prescription drug, so a licensed prescriber has to evaluate you and authorize it. Who may hold the syringe is a separate question, and it varies. Colorado, Georgia and Illinois each let a physician delegate the injection to a trained unlicensed person under written conditions and supervision, while other states on this list keep it with licensed clinicians. In none of the 14 states we checked did a source authorize injection under an esthetics license.

By Medical Spa Providers Editorial Team (Researched from the primary sources listed at the end of this guide)Updated 2026-10-12

1. The One Rule That Holds in Every State

Botulinum toxin and dermal fillers are prescription medical products, so somewhere in the chain there must be a licensed prescriber who evaluates you and authorizes the treatment. In none of the 14 states on this page can a business sell you an injection without a licensed prescriber standing behind it, the way it can sell you a facial.

What varies is the second question: who is permitted to put the needle in, and how close the prescriber has to be while it happens. Some states write that out in detail. Colorado, for example, defines the injection of any substance into the human body as a Medical-Aesthetic Service that constitutes the practice of medicine, then spells out the conditions under which a physician may delegate it. Others leave the answer scattered across a medical practice act, a nurse practice act and a cosmetology act that were never written to be read together.

That drafting gap makes the rules hard to check. A separate failure, about product rather than drafting, is what put people in hospital in 2024. In its 2024 investigation of harmful reactions after counterfeit or mishandled botulinum toxin injections, the CDC recorded 17 people across 9 states who reported reactions between November 4, 2023 and April 11, 2024. Thirteen of them, 76 percent, were hospitalized, and 6, or 35 percent, were treated with botulism antitoxin. Those are the figures in the CDC's final update of June 24, 2024, when it closed the investigation. The FDA's parallel notice observed that the incidents occurred when counterfeit product was injected by licensed and unlicensed individuals and in non medical or unlicensed settings.

This page covers the 14 states whose injection rules we have read in full. The register also lists Kentucky (Lexington and Louisville); that state is not in this table yet. This is a reading of primary sources, not legal advice, and it is a snapshot of rules that change.

2. Who May Inject in the 14 States This Directory Covers

Each cell below reflects a statute, administrative code section or board rule read directly, and every one of them is listed in the sources at the end of this guide. The last column names the board that governs the question rather than the citation. Where a state does not address a question in a source we could reach, the cell says so rather than guessing, because a plausible guess about a licensing rule is worse than an honest gap.

Read the supervision column as closely as the first one. In several states the question is not whether a given license can inject but how present the supervising physician has to be, and that is the detail that separates a well run clinic from a risky one.

The exam column refers to the evaluation a prescriber must perform before a prescription drug is authorized for you. Only a few of these states put a specific requirement in statute or rule. That is not the same as an exam being optional.

State	Who may inject neurotoxins or fillers	Supervision or delegation requirement	Exam before treatment	Governing board
Arizona	Licensed health professionals only, each within their own scope. Estheticians and cosmetologists are not health professionals under the statute that governs cosmetic drug administration.	The statute's supervision provision covers supervising another health professional in the use of a laser or IPL device, not the administration of drugs. For drugs administered for cosmetic purposes it says only that a health professional may do so within their own scope. Practical nursing is performed under the supervision of a physician or registered nurse.	Not clearly addressed by the board: ask the clinic which licensed provider examines and injects, and verify the license.	Arizona Medical Board; Arizona State Board of Nursing
California	Physicians, and licensed clinicians acting within their scope. A registered nurse may administer medications and therapeutic agents ordered by a physician. Skin care licensees may not perform work that ablates or destroys live tissue.	Practicing medicine without a license is prohibited. A nurse administers on a prescriber's order rather than independently.	Prescribing a dangerous drug without an appropriate prior examination and a medical indication is unprofessional conduct. The statute states the exam need not be synchronous and may use telehealth, a self screening tool or a questionnaire, if the standard of care is met.	Medical Board of California; Board of Registered Nursing; Board of Barbering and Cosmetology
Colorado	Injection of any substance is a Medical-Aesthetic Service and the practice of medicine. A physician may delegate it, including to an unlicensed delegatee, after personally assessing that person's training and observing the procedure.	When a physician delegates to an unlicensed delegatee, the physician must be on the premises and readily available, unless specific and detailed written protocols and adequate written emergency protocols are in place. Chart review within 14 days; on site monitoring at least every two weeks. Rule 800 states that it does not govern delegation to physician assistants or to individuals regulated by the Board of Nursing, so it is not the presence rule for a nurse injector.	Delegated services must occur within an appropriate physician patient relationship. The rule lists a physician performed initial consultation among the factors establishing one.	Colorado Medical Board, Rule 800 (3 CCR 713-30)
Florida	Physicians, and physician assistants and advanced practice registered nurses under physician supervision or protocol. An autonomous APRN may practice only in primary care, and no source we read says whether cosmetic injection counts. For registered nurses, the Board of Nursing has answered individual petitions rather than issuing a general rule: in the six 2023 and 2024 orders we read it allowed an RN to be delegated Botox under a physician's direction, two of them fillers as well. No source we found addresses practical nurses. The cosmetology rule puts injections beyond a cosmetology license or facial specialist registration.	Each nursing order applies only to that petitioner's circumstances. The May 2024 orders required the delegation to come from a physician (MD or DO), defined direct supervision as the physician having visualization of the injection, and required the nurse's role to be stated in the patient's informed consent. A physician who supervises an APRN or PA at an office offering mainly aesthetic skin care without an onsite physician must be board certified or board eligible in dermatology or plastic surgery and must post the hours the physician is present.	No general rule found. In the approved nursing petitions we read, a physician assessed the patient and wrote the treatment order before delegating the injection; the first, in July 2023, named the muscles and the units per injection site.	Florida Board of Medicine; Board of Nursing; Board of Cosmetology (Department of Business and Professional Regulation)
Georgia	A physician may delegate subcutaneous and intramuscular injections to an unlicensed medical assistant. The rule is general and does not name cosmetic injectables.	A physician, physician assistant or advanced practice nurse must be on site for a medical assistant to give a subcutaneous or intramuscular injection. An APRN works under a nurse protocol agreement filed with the board.	Not clearly addressed by the board: ask who performs the injection, what license that person holds if any, which physician delegated the task, and who is on site.	Georgia Composite Medical Board; Georgia Board of Nursing
Illinois	A physician may delegate patient care tasks to a practical nurse, registered nurse or other licensed person within that person's own licensing act, and to an unlicensed person with appropriate training and experience.	For an unlicensed person, a licensed health care professional must be on site to provide assistance. The task must also fall within the delegating physician's own scope.	The statute requires a delegated task to sit within a physician patient relationship. Its only written examination provision waives an on site physician exam before a non ablative laser procedure at a laser hair removal facility, on four listed conditions, so it sets no examination rule for an injection.	Illinois Department of Financial and Professional Regulation
Massachusetts	Physicians, and registered and licensed practical nurses on an authorized prescriber's order. The Board of Registration in Nursing's Advisory Ruling 13-01, revised January 10, 2024, puts botulinum toxins and absorbable fillers within RN and LPN scope, but unless they are advanced practice nurses with prescriptive authority they may not choose the drug, dose, device or settings, or buy the drug. Nurse practitioners prescribe under guidelines until they qualify for independent practice. Physician assistants work under a physician's continuous supervision. Aestheticians, cosmetologists and electrologists may not inject.	A nurse injects on a prescriber's order rather than independently. Physician assistant supervision must be continuous but does not require the physician's personal presence. Whether a prescriber must be on site when a nurse injects is not clearly addressed in the rules we read, so ask.	The Board of Registration in Medicine's prescribing policy says a physician must take and record an appropriate medical history and exam at the first encounter before prescribing. A 2004 consumer advisory on Botox, as posted by the state, says treatment presupposes a doctor's thorough exam and complete history; it is an older advisory, not a regulation.	Board of Registration in Medicine; Board of Registration in Nursing; Department of Public Health
Nevada	Treating a condition by any means is the practice of medicine. A registered nurse administers medications and treatments as prescribed by a physician, PA or APRN and may not perform medical diagnosis. Advanced esthetician scope covers microneedling and medium depth peels, not injections.	A prescriber's order is required. Practical nurses act under direction. Advanced esthetic procedures are defined as performed for esthetic purposes and not to treat an ailment.	Not clearly addressed by the board: ask the clinic which licensed provider examines and injects, and verify the license.	Nevada State Board of Medical Examiners; State Board of Nursing; State Board of Cosmetology
New York	Registered professional nursing includes executing a medical regimen prescribed by a physician or other authorized prescriber. Practical nurses act under the direction of a registered nurse or physician. Nurse practitioners collaborate under a written practice agreement.	A registered nurse injects on a prescriber's regimen rather than independently; the statute does not require the prescriber to be present. A nurse practitioner with more than 3,600 hours of practice is not required to hold a collaboration agreement or written protocols under the provision in force on the date this page was read, which the published text marks as effective until July 1, 2030.	Not clearly addressed in a board source we could reach: ask the clinic which licensed provider examines and injects, and verify the license.	NYS Education Department, Office of the Professions, State Board for Nursing
Pennsylvania	A medical doctor may inject, and may delegate a medical service to another health care practitioner or a technician only if the doctor knows that person is trained and competent and the delegation does not create an undue risk. A doctor may not delegate work whose performance or complications call for knowledge nonphysicians do not ordinarily have. Registered nurses may administer a drug as ordered. The rules we read do not specifically say whether a cosmetic injection may be delegated to an unlicensed technician. An esthetics license is not a license to inject.	The delegation rule sets no fixed on-site requirement. The doctor stays responsible and must be available as the difficulty, the skill of the person and the patient's risk require, and the patient must be told the service is delegated and must not object. Certified registered nurse practitioners work under a collaborative agreement; the physician must be immediately available, which may be by phone or telecommunications. Physician assistant supervision does not require the physician on site.	The State Board of Medicine's written exam-before-prescribing rule covers controlled substances. We found no rule that expressly requires a prescriber's exam before a cosmetic neurotoxin or filler treatment, so ask who examines you and who injects.	State Board of Medicine; State Board of Osteopathic Medicine; State Board of Nursing; State Board of Cosmetology
Tennessee	The medical spa registration rule names a medical director or supervising physician responsible for the cosmetic medical services, but does not enumerate which licenses may inject. Ask the clinic which licensed provider examines and injects, and verify the license.	A medical spa must register annually with the Board of Medical Examiners and name a medical director or supervising physician who is an MD or DO with an active Tennessee license and an active Tennessee practice, and who attests to accepting responsibility for the services. Operating unregistered is unprofessional conduct.	Not clearly addressed by the board: ask the clinic which licensed provider examines and injects, and verify the license.	Tennessee Board of Medical Examiners
Texas	The Texas Medical Board classes nonsurgical medical cosmetic procedures, including injecting medication or substances for cosmetic purposes, as the practice of medicine that a physician may delegate and supervise.	Physician delegation under 22 Tex. Admin. Code chapter 169, subchapter E. The delegating physician must confirm the injector's training and hold a signed written protocol, and a physician, physician assistant or advanced practice registered nurse must be onsite during the procedure or immediately available for emergency consultation. The state licensing agency for cosmetology states plainly that medical cosmetic procedures fall to the Texas Medical Board, not to it.	Before the delegated act, a physician, or a physician assistant or advanced practice registered nurse acting under that physician's delegation, must establish a practitioner patient relationship.	Texas Medical Board; Texas Board of Nursing; TDLR for cosmetology and laser hair removal
Utah	The statute defines a cosmetic medical procedure to include the injection of medication or a substance, including a neurotoxin or a filler, for cosmetic purposes, and makes performing one part of the practice of medicine. The same section carves out that conduct when it is performed under a license issued in another chapter of the same title, so another licensee may inject only so far as that person's own licensing chapter authorizes it.	The practice standard on supervising cosmetic medical procedures addresses ablative procedures only, including a narrow exception letting a physician delegate erbium full ablation or CO2 fractionated resurfacing to an advanced practice registered nurse. It writes no supervision rule for injection, so that question was not reached in the sources we could read.	Not clearly addressed by the board: ask the clinic which licensed provider examines and injects, and verify the license.	Utah Division of Professional Licensing
Washington	A registered nurse may administer medications, treatments, tests and inoculations at or under the general direction of a physician, PA, ARNP or other listed provider, whether or not tissue is penetrated.	A registered nurse may not delegate the administration of medications except in narrow listed situations, which limits how far an injection task can be handed down.	Not clearly addressed in a board source we could reach: ask the clinic which licensed provider examines and injects, and verify the license.	Washington Medical Commission; Nursing Care Quality Assurance Commission

3. How to Read This Table Without Getting It Wrong

A blank in the exam column does not mean a state permits treatment without an evaluation. It means the state has not written a specific requirement into the statute or board rule we could reach, so the duty rests on the general standard of care and on the prescriber's own license. Every state can discipline a prescriber who authorizes a drug carelessly.

A state that permits delegation to an unlicensed person is not automatically the riskier state. Colorado permits it and then attaches detailed conditions: personal assessment of the delegatee, over the shoulder observation before unsupervised work, a physician on the premises unless detailed written protocols exist, monitoring at the treatment site at least every two weeks, and chart review within fourteen days. A permissive headline rule with strict conditions can protect a patient better than a restrictive rule nobody audits.

Notice also that these rules govern the provider, not the product. None of these state licensing rules polices where a clinic bought the vial, so that is a separate question you have to ask separately.

Finally, several of these states regulate lasers and energy devices under entirely different rules from injections. Arizona certifies aestheticians and cosmetologists as laser technicians through its health department while excluding them from the category allowed to administer drugs for cosmetic purposes. Do not read a laser permission as an injection permission.

4. What Delegation Actually Means, and Where It Stops

Delegation is a physician handing a specific task to a specific person after confirming that person can perform it. It is not a blanket permission attached to a job title, and in the states that define it carefully it comes with paperwork.

Illinois is a clean example. A physician may delegate patient care tasks to a practical nurse, registered nurse or other licensed person acting within their own licensing act, and to an unlicensed person who possesses appropriate training and experience, but only in an office or practice setting, only within a physician patient relationship, and only when a licensed health care professional is on site to provide assistance. Strip out any of those conditions and the delegation no longer holds.

Georgia draws its line by task rather than by procedure. Its board rule permits a physician to delegate subcutaneous and intramuscular injections to an unlicensed medical assistant, and requires a physician, physician assistant or advanced practice nurse to be on site while that happens. The rule is written for general medical practice and does not name cosmetic injectables, which is a genuine ambiguity rather than a permission.

Washington limits delegation from the nursing side instead. A registered nurse there may administer medications under a prescriber's general direction, but the statute expressly says a registered nurse may not delegate the administration of medications except in a short list of situations. A nurse cannot hand the syringe to an assistant.

The practical version for a patient: ask who is injecting, what license that person holds, who the supervising or delegating physician is, and where that physician is while you are being treated. Every one of those is a question the state would ask too.

5. Where Estheticians Fit, and Where They Do Not

In none of these 14 states did we find a source authorizing an esthetician to inject a neurotoxin or a filler under an esthetics license. Cosmetology statutes describe surface work, and several say so in words that exclude medical procedures outright.

California defines the practice of skin care as beautifying the skin in ways that do not result in the ablation or destruction of live tissue, and separately excludes hair removal by lasers or light waves. Florida defines cosmetology services as performed for aesthetic rather than medical purposes. Nevada defines an advanced esthetic procedure as one performed for esthetic purposes and not for the treatment of a medical, physical or mental ailment, and lists what counts: microneedling, medium depth chemical peels, nonablative esthetic medical procedures and similar work. Injections are not on that list.

Arizona makes the boundary structural rather than descriptive. The statute that allows a person to administer drugs for cosmetic purposes applies to health professionals, and the definition of health professional enumerates the licensing chapters that qualify. Barbering and cosmetology is not among them, even though the same state separately certifies aestheticians to operate cosmetic lasers.

This is not a judgment about skill. Many estheticians are skilled at the work their license covers, and an experienced esthetician working alongside a nurse injector is a normal and legitimate staffing model. The point is narrower: an esthetics license is not an injection license, and a clinic that blurs the two is telling you something about how it runs.

6. The Exam Before Treatment: What a Few States Put in Writing

Only a minority of these 14 states writes a specific pre treatment evaluation requirement into statute or rule, and the ones that do are worth reading closely because they are frequently misdescribed.

California's statute makes prescribing a dangerous drug without an appropriate prior examination and a medical indication unprofessional conduct. The same subsection then states that an appropriate prior examination does not require a synchronous interaction between the patient and the licensee and can be achieved through telehealth, including a self screening tool or a questionnaire, provided the licensee complies with the appropriate standard of care. Anyone telling you that California bans questionnaire based evaluation outright is describing a rule the statute does not contain.

Colorado approaches it through the relationship rather than the encounter. Its rule requires delegated services to be provided in the context of an appropriate physician patient relationship, and lists a physician performed initial consultation first among the factors that establish one.

Illinois writes an examination rule only for lasers. Its delegation statute waives an on site physician examination before a non ablative laser procedure when four conditions are met, among them that the laser hair removal facility follows a physician delegation protocol, that the examination is performed by an advanced practice registered nurse, and that a physician is available to respond promptly to questions or complications. That provision is about laser facilities. It sets no examination rule for an injection, so in Illinois the duty before an injection rests on the physician patient relationship the statute requires and on the prescriber's standard of care.

Everywhere else on this list, the duty is real but unwritten in the sources we could reach. It lives in the prescriber's standard of care rather than in a numbered rule, which is precisely why asking who examined you, and when, is a fair question in any state.

7. How to Verify a Provider Yourself

Start by getting a name and a license type in writing, not a job title. Injector, specialist and aesthetic provider are marketing words. RN, NP, PA, MD and DO are license classes a state board can confirm.

Look that person up on the board named in the last column of the table. Medical boards and nursing boards both run free public license lookups, and both show discipline history. A license that does not appear, or appears under a different name, is worth resolving before you book rather than after.

Ask who the supervising or delegating physician is and whether that physician is on site during treatment. In Colorado the rule answers that specifically when the injector is an unlicensed delegatee, and leaves nurses to the Nurse Practice Act instead. In Tennessee, a medical spa must be registered with the Board of Medical Examiners under a named medical director who has attested to accepting responsibility for the services, so the clinic should be able to name that person without hesitating.

Ask where the product comes from. The FDA's 2024 notice reported that the counterfeit products it found appeared to have been purchased from unlicensed sources, so ask whether the vial was bought from the manufacturer or an authorized distributor.

If a clinic responds to any of these questions with irritation rather than an answer, that reaction is itself information. Nothing on this list is intrusive, and a well run practice hears all of it regularly.

8. Rules Verified as of September 19, 2026

Every statute, board rule and administrative code section cited on this page was read directly on September 19, 2026. Each is listed in the sources for this guide so you can check it yourself rather than taking our reading on trust.

State licensing rules change, and they change in both directions. Legislatures expand and contract nurse practitioner autonomy, cosmetology boards add and remove device categories, and medical boards issue declaratory rulings that shift a settled understanding without amending a single statute. Nevada created its advanced esthetician category as recently as 2021 and amended the list of permitted procedures in 2023. Tennessee's medical spa registration rule took effect in 2018 and did not exist before that.

A handful of sources were not reachable from a public connection while this page was researched: the Arizona State Board of Nursing's advisory material and the Tennessee statute underlying its medical spa rule. Those gaps are marked in the table rather than filled in. The Florida Board of Nursing's declaratory statements, unreachable at first, were read on September 24, 2026 at their new address, and the Florida row was rewritten from them that day. Texas is a separate case. The Texas Medical Board repealed 22 Tex. Admin. Code 193.17 effective January 9, 2025 and moved these requirements into chapter 169, subchapter E, and the state rules portal serves that chapter through an interactive viewer rather than as plain text, so the rule text was first read from a public copy of the code and then checked against the official portal on September 24, 2026. Pennsylvania and Massachusetts rows were added on September 25, 2026 from the same statutes, rules and board pages already cited on those states' register pages.

This page is educational information about licensing rules. It is not legal advice, and it is not a substitute for asking the board directly or consulting a lawyer if a specific arrangement matters to you.

Rules verified as of September 19, 2026, and they change

Every cell in the table above was read from the state's own statute, administrative code or board rule. The original 12 rows were read on September 19, 2026, the Florida row again on September 24, 2026, and the Pennsylvania and Massachusetts rows on September 25, 2026 from the sources listed below. Licensing rules are amended regularly and boards issue rulings that shift interpretation without changing statutory text. This page is educational information about scope of practice, not legal advice. Confirm current rules with the board before relying on them.

14 states reviewed · Statutes and board rules read directly · Unclear rules marked, not guessed

Questions about who is allowed to inject

Who can inject Botox?

A licensed prescriber must evaluate you and authorize the treatment. Who may perform the injection is a separate question that each state answers for itself. In most states on this list the injector is a physician or a clinician acting within another license, such as a physician assistant, nurse practitioner or registered nurse. Colorado, Georgia and Illinois also let a physician delegate the injection to a trained unlicensed person under defined supervision. No state we reviewed authorizes injection under an esthetics or cosmetology license.

Who can inject Botox in Florida?

Physicians can, and physician assistants and advanced practice registered nurses can within physician supervision or a written protocol; an autonomous APRN is limited to primary care, and no source we read says whether cosmetic injection counts. For registered nurses, the Florida Board of Nursing has ruled on individual petitions: in the six 2023 and 2024 orders we read, it allowed an RN to be delegated Botox under a physician's direction, and in two of them fillers too. Its May 2024 orders required a physician (MD or DO) to delegate, the physician to visualize the injection, and the nurse's role to be disclosed in your informed consent. Each order applies only to that nurse, and no source we found addresses practical nurses, so ask who examines you, who injects, and verify each license.

Can an esthetician do microneedling?

It depends entirely on the state. Nevada names microneedling as an advanced esthetic procedure that a licensed advanced esthetician may perform, provided it is done for esthetic purposes and not to treat an ailment. Washington licenses a separate master esthetician class under its cosmetology chapter, so an advanced tier exists there too, and California limits skin care to work that does not ablate or destroy live tissue. None of the sources we read authorizes injection under any esthetics license, advanced or not. Check your own state board before assuming.

What is a good faith exam?

It is the evaluation a prescriber performs before authorizing a prescription treatment for you. California's statute is the clearest on this list: prescribing a dangerous drug without an appropriate prior examination and a medical indication is unprofessional conduct, and the exam need not be synchronous if the standard of care is met. Most states leave the requirement to the prescriber's general standard of care rather than a numbered rule.

Can a registered nurse inject Botox without a doctor present?

Sometimes, and the answer is state specific. Washington lets a registered nurse administer medications under a prescriber's general direction, which does not require physical presence. Colorado's Rule 800 requires a physician on the premises unless specific detailed written protocols and emergency protocols are in place, but that rule governs delegation to unlicensed people and expressly does not govern delegation to those regulated by the Board of Nursing. Georgia requires a physician, PA or APRN on site when an unlicensed medical assistant gives an injection. Ask the clinic which rule applies to them.

Do medical spas have to be registered with the state?

In most states, no. Tennessee is the clear exception on this list: a medical spa offering cosmetic medical services must register annually with the Board of Medical Examiners, name a medical director or supervising physician who is an MD or DO with an active Tennessee license and practice, and file an attestation that the physician accepts responsibility for the services. Operating without current registration is unprofessional conduct for that physician.

Is it illegal to inject Botox without a license?

It depends on the state, and the license is only half the question. Injecting a prescription drug is a medical act, and doing it without a license and without a valid delegation is unlawful. But Colorado, Georgia and Illinois each let a physician delegate the injection itself to a trained unlicensed person, each on its own written conditions, so an unlicensed injector is not automatically unlawful in those three. Ask who delegated the task, on what written protocol, and who is present. The FDA's 2024 counterfeit botulinum toxin notice reported that those incidents occurred when counterfeit product was injected by licensed and unlicensed individuals and in non medical or unlicensed settings.

How do I check if my injector is licensed?

Ask for the person's full name and license type, then search the state board's public license lookup. Medical boards and nursing boards both publish free verification tools that show license status and discipline history. Also ask who the supervising or delegating physician is and whether that person is on site, since several states set their supervision requirement around exactly that question.

Sources

Primary references behind this guide. Each link opens the publisher’s own page.

A.R.S. 32-3233, Lasers; IPL devices; authorized use; authorized supervision (subsection A also covers administering drugs or devices for cosmetic purposes)Arizona State Legislatureaccessed 2026-09-19
A.R.S. 32-3201, Definitions (health professional)Arizona State Legislatureaccessed 2026-09-19
A.R.S. 32-516, Aestheticians; cosmetologists; cosmetic laser and IPL device use; certificationArizona State Legislatureaccessed 2026-09-19
A.R.S. 32-1601, Nurse Practice Act definitionsArizona State Legislatureaccessed 2026-09-19
Cal. Bus. & Prof. Code 2052, Practice of medicine without a licenseCalifornia Legislative Informationaccessed 2026-09-19
Cal. Bus. & Prof. Code 2242, Prescribing without an appropriate prior examinationCalifornia Legislative Informationaccessed 2026-09-19
Cal. Bus. & Prof. Code 2725, Scope of registered nursing practiceCalifornia Legislative Informationaccessed 2026-09-19
Cal. Bus. & Prof. Code 7316, Practice of skin care definedCalifornia Legislative Informationaccessed 2026-09-19
Colorado Medical Board Rule 800, Delegation and Supervision of Medical Services (3 CCR 713-30)Colorado Secretary of State, Code of Colorado Regulationsaccessed 2026-09-19
Fla. Stat. 464.003, Nurse Practice Act definitionsFlorida Legislatureaccessed 2026-09-19
Fla. Stat. 477.013, Cosmetology definitionsFlorida Legislatureaccessed 2026-09-19
Ga. Comp. R. & Regs. 360-3-.05, Medical Assistants, Polysomnography Technologists, and Radiology TechnologistsGeorgia Secretary of State, Rules and Regulationsaccessed 2026-09-19
Ga. Comp. R. & Regs. 360-32, Nurse Protocol AgreementsGeorgia Secretary of State, Rules and Regulationsaccessed 2026-09-19
225 ILCS 60/54.2, Physician delegation of authorityIllinois General Assemblyaccessed 2026-09-19
225 ILCS 65/50-75, Nursing delegation by a registered professional nurseIllinois General Assemblyaccessed 2026-09-19
NRS 630.020, Practice of medicine definedNevada Legislatureaccessed 2026-09-19
NRS 632.017 and 632.018, Practice of practical and professional nursing definedNevada Legislatureaccessed 2026-09-19
NRS 644A.012, Advanced esthetic procedure definedNevada Legislatureaccessed 2026-09-19
NY Education Law Article 139, Nursing (section 6902)New York State Education Department, Office of the Professionsaccessed 2026-09-19
Rules of the Tennessee Board of Medical Examiners, Chapter 0880-02 (Medical Spa Registration, 0880-02-.24)Tennessee Secretary of Stateaccessed 2026-09-19
22 Tex. Admin. Code ch. 169, subch. E, Other Delegated Acts (sections 169.25 to 169.28, adopted 50 TexReg 0348, eff. Jan. 9, 2025, replacing repealed section 193.17)Texas Secretary of State, Texas Administrative Code, Title 22 Part 9accessed 2026-09-19
Medspas at a Glance (TDLR AAG FORM-029, Sept. 2025)Texas Department of Licensing and Regulationaccessed 2026-09-19
Utah Code 58-67-102, Definitions (practice of medicine includes cosmetic medical procedures)Utah State Legislatureaccessed 2026-09-19
Utah Code 58-67-805, Supervision of cosmetic medical proceduresUtah State Legislatureaccessed 2026-09-19
RCW 18.79.260, Registered nurse, activities allowed, delegation of tasksWashington State Legislatureaccessed 2026-09-19
RCW 18.16.020, Cosmetology and esthetics definitionsWashington State Legislatureaccessed 2026-09-19
Counterfeit Version of Botox Found in Multiple StatesU.S. Food and Drug Administrationaccessed 2026-09-19
Investigation Update on Harmful Reactions Linked to Counterfeit BotoxCenters for Disease Control and Preventionaccessed 2026-09-19
Final Order DOH-23-0849-DS-MQA, In re Petition of Jessica A. James, RN (filed July 7, 2023)Florida Board of Nursing, Final Order on Petition for Declaratory Statement (published by Florida Department of Health)accessed 2026-09-24
Final Order DOH-23-1313-DS-MQA, In re Petition of Diana Lange, RN (filed Oct. 19, 2023)Florida Board of Nursing, Final Order on Petition for Declaratory Statement (published by Florida Department of Health)accessed 2026-09-24
Final Order DOH-24-0636-DS-MQA, In re Petition of Sydney Canfield, RN (filed May 10, 2024)Florida Board of Nursing, Final Order on Petition for Declaratory Statement (published by Florida Department of Health)accessed 2026-09-24
Fla. Stat. 120.565, Declaratory statement by agenciesFlorida Legislature, Online Sunshine (2026 Florida Statutes)accessed 2026-09-24
Fla. Stat. 464.012, Licensure of advanced practice registered nursesFlorida Legislature, Online Sunshine (2026 Florida Statutes)accessed 2026-09-24
Fla. Stat. 464.0123, Autonomous practice by an advanced practice registered nurseFlorida Legislature, Online Sunshine (2026 Florida Statutes)accessed 2026-09-24
Fla. Stat. 458.347, Physician assistantsFlorida Legislature, Online Sunshine (2026 Florida Statutes)accessed 2026-09-24
Fla. Stat. 458.348, Formal supervisory relationships, standing orders, and established protocolsFlorida Legislature, Online Sunshine (2026 Florida Statutes)accessed 2026-09-24
Fla. Admin. Code R. 61G5-18.00015, Cosmetology definitions (amended 10-20-21)Florida Department of State, Florida Administrative Code (flrules.org)accessed 2026-09-24
Medical Spa Services Advisory (Department of Public Health, 12/20/2013)Massachusetts Department of Public Healthaccessed 2026-09-25
Board of Registration in Nursing Advisory Ruling 13-01, Cosmetic and Dermatologic Procedures (revised January 10, 2024)Massachusetts Board of Registration in Nursingaccessed 2026-09-25
243 CMR 2.00, Licensing and the Practice of MedicineMassachusetts Board of Registration in Medicineaccessed 2026-09-25
49 Pa. Code § 18.402, DelegationPennsylvania State Board of Medicineaccessed 2026-09-25
49 Pa. Code § 21.14, Administration of drugsPennsylvania State Board of Nursingaccessed 2026-09-25
The Professional Nursing Law, section 2 (63 P.S. § 212), DefinitionsPennsylvania General Assemblyaccessed 2026-09-25

Related guides

Find a provider

Find a clinic that can answer these questions

Browse medical spas in your state and compare injector credentials, named medical oversight and how each practice describes its supervision before you book.

Browse med spas

Educational information only. This page summarizes publicly available statutes, administrative codes and state board rules as read on September 19, 2026 (Florida on September 24, 2026), and is not legal advice, medical advice or a legal opinion. Licensing rules change and boards issue interpretations that alter how a rule applies. Confirm current requirements with the relevant state board, and consult a licensed attorney for any specific situation.

For med spa owners

Own a med spa? Claim your listing.

People compare providers here by rating and services. Make sure your listing is present, current, and correct. It's free.

Claim your listing →