Who Can Inject Botox in North Dakota? Nurses and Boards

This guide covers three state boards. The Board of Medicine licenses physicians (MDs and DOs) and physician assistants under the Medical Practice Act, NDCC chapter 43-17. The Board of Nursing licenses RNs, LPNs and APRNs under the Nurse Practices Act, chapter 43-12.1. The State Board of Cosmetology licenses estheticians and advanced estheticians under chapter 43-11.

None of the board pages or Century Code chapters reviewed for this guide names Botox, neuromodulators or dermal fillers. The Board of Nursing's aesthetic guidance, in a section contributed by the Board of Pharmacy, says that because North Dakota does not license clinics, the prescriber must be the responsible party for receiving and storing legend drugs. The Board of Medicine says it has no jurisdiction over health care facilities.

The Board of Nursing's Nursing Practice FAQ answers the question directly. It says an RN with evidence of comprehensive, specialized and accredited training, certification and competencies may inject FDA approved medical aesthetic or cosmetic agents, as part of a medically prescribed treatment plan that includes the prescriber's documented initial assessment of each client. It says national specialty certifications are preferred, and that training includes at a minimum a comprehensive didactic component and a supervised practicum. The FAQ page shows "12/2023" and a last modified date of February 13, 2025.

The board's longer practice guidance, Role of the Nurse in Aesthetic Practices in Retail Settings, was last revised in January 2026. It describes itself as guidance on interpreting the Nurse Practices Act and says that board approved guidance does not carry the force and effect of law or rules. It uses "retail settings" to mean medical offices, clinics and other business models, including medical spas, independent aesthetic clinics and mobile aesthetic services, and says the Board of Nursing has no jurisdiction or oversight over independent clinics or retail settings.

Under that guidance, an RN needs an order from a prescriber before giving aesthetic agents. The prescriber must take a documented history and physical assessment and develop a client-specific plan before any treatment. A change of treatment type, treatment area, product or dose requires a new assessment by the prescriber first. Selecting a medication or determining a dosage is not within RN scope, and an RN cannot independently purchase drugs or equipment for aesthetic treatments.

The FAQ accepts telehealth for the prescriber's assessment, but says photos of a client do not count as telehealth and are not an appropriate assessment. The guidance adds that a general medical clearance for all services is not acceptable. For how delegation works more generally, see our RN injector guide.

The aesthetic guidance says it is not intended to apply to the licensed practical nurse. On the Board of Nursing pages reviewed, we found no statement that addresses LPNs injecting aesthetic agents. The FAQ links a board-approved RN-LPN Scope of Practice Comparison Chart, which this guide did not review. The Nurse Practices Act defines an LPN as a nurse who practices dependently under the supervision of an RN, specialty practice RN, APRN or licensed practitioner. The FAQ says prescribing a drug is not within LPN or RN scope.

An APRN with prescriptive authority is one of the three kinds of prescriber the guidance names, along with physicians and physician assistants. The guidance says nursing scope excludes medical diagnosing, determining medical treatment, and prescribing or dispensing FDA approved agents and devices, unless the nurse is an APRN with prescriptive authority. If an APRN is both your prescriber and your injector, check the APRN license itself rather than assuming the title settles the question.

NDCC 43-17-01 defines the practice of medicine and lists who is regarded as practicing it. The list includes a person who suggests, recommends or prescribes any form of treatment for the intended relief or cure of any physical or mental ailment, with the intention of receiving, directly or indirectly, any fee, gift or compensation. The Board of Medicine's Laws and Rules page says the board is not authorized to issue advisory or legal opinions. We found no board statement on cosmetic injections or med spas on the board pages reviewed.

Under NDCC 43-17-02.1, a physician assistant may provide a legal medical service for which the PA is prepared by education, training and experience and is competent to perform. A PA with fewer than four thousand hours of approved practice must have a written collaborative agreement with a physician. A PA must practice at a licensed health care facility, a facility with a credentialing and privileging system, a physician-owned facility or practice, or a facility or practice the board approves.

In the nursing guidance, the prescriber who assesses you and orders the treatment can be a physician or a PA. Ask the practice which one it is, and check that person's license with the Board of Medicine.

NDCC 43-11-27.2 limits cosmetology, manicuring and esthetics to noninvasive care. A cosmetologist, manicurist or esthetician may not alter, cut, puncture or damage any living cells, whether superficially or through laser, light or energy. The chapter's definition of esthetics excludes any procedure invading living tissue below the stratum corneum layer of the epidermis.

The Legislature's page for HB 1126 (2025) shows that the bill passed, was signed by the Governor in April 2025 and was requested by the State Board of Cosmetology. Its title includes advanced esthetician licensing. The Board of Cosmetology says advanced esthetics became a regulated license category effective January 1, 2026.

In the current chapter 43-11, advanced esthetics includes advanced chemical peels, microneedling, nonablative laser, light or energy procedures and extractions using lancets. It excludes procedures to treat a medical, physical or mental ailment, and ablative procedures. Injections are not among the procedures listed. An advanced esthetician also needs board-approved certification before using microneedling devices, nonablative devices or advanced chemical peels.

The board's advanced esthetics page says these procedures must be performed in a licensed establishment, that a medical spa employing board licensees must be licensed as an establishment, and that medical supervision does not replace board licensure. NDCC 43-11-02 says the chapter does not apply to advanced esthetic procedures provided by a licensed physician or PA practicing under chapter 43-17, a nurse practicing under chapter 43-12.1, or a dentist or dental surgeon, optometrist or chiropractor practicing under their own chapters. The board's page says a medical provider can perform these services without a board license if acting strictly within the scope of their medical license, and that board licensees the provider employs must still follow board laws and rules. Our esthetician scope guide covers the wider picture.

Search the board that licenses the person. The Board of Medicine's Verify License Status page covers physicians and physician assistants. It says the site is a primary source for board data, updated in real time, and that clicking a name shows details including disciplinary history. The page says disciplinary summaries and documents are available from 2012 forward and that practice specialties and board certifications are self-proclaimed. The Board of Nursing's verification portal searches by name, license number or NCSBN ID and links to the Nursys national licensure and disciplinary database.

For an esthetician or advanced esthetician, the State Board of Cosmetology's home page carries a notice that its public license lookup is not yet available and is expected to launch in January 2027, and asks you to contact the Board office until then. The same page also links a License Verification tool that it describes as the Board's online verification system, so the page is not consistent; call the Board office if the link does not give you a result. Separately, NDCC 43-65-02 requires an advertisement for health care services that names a health care practitioner to identify the type of license held. Chapter 43-65 limits "health care practitioner" to listed license types, such as physicians, nurses and physician assistants, and the list does not include estheticians. It also requires those practitioners to wear a photo name tag showing their license type during patient encounters, with exceptions that include the office of a solo practitioner or of a single type of provider.

To complain about a physician or PA, use the Board of Medicine's complaint form. Its FAQ says a complaint cannot be filed by telephone and that the board strongly discourages anonymous complaints. The board says complaints and its investigations are confidential, while formal actions are public. It cannot award money damages or force a licensee to provide further treatment, and it tells complainants to direct health care facility inquiries and complaints to the Department of Health and Human Services.

For a nurse, use the Board of Nursing's online complaint portal and include a written synopsis with as much detail and evidence as possible. The portal says the nurse named may be given a copy, your complaint may be an open or public record, and cases are resolved within 45 to 60 days on average, though a case can take from a few weeks to a year or more. The Board of Cosmetology says complaints must be signed and it cannot accept anonymous ones. Our complaint guide explains what to document.

When comparing North Dakota med spas, including the Fargo listings, ask four things: who assesses you and orders the treatment, whether that person is a physician, PA or APRN with prescriptive authority, who will inject, and how you reach the prescriber if you react badly afterward. The Board of Nursing guidance says clients must be monitored for adverse reactions, which must be documented and communicated to the prescriber.

If a microneedling, advanced chemical peel or nonablative laser appointment is with an esthetician, ask whether the person holds an advanced esthetician license and the matching certification, and for laser or IPL whether the board's supervision requirements are met. Chapter 43-11 lets a basic esthetician do some lower-strength cosmetic peels, and it bars ablative procedures for estheticians and advanced estheticians alike. Our consultation checklist organizes the rest of your questions, and the state injector guide covers other states. A directory listing does not verify anyone's scope.