Who Can Inject Botox in Wyoming? Nurse and Board Rules

If you are comparing med spas in Cheyenne or elsewhere in Wyoming, ask for the full name and license type of the person who will inject you, and separately who examined you and ordered the treatment. Those can be two different people, licensed by different boards.

Most of the detail on cosmetic injections comes from one document: the State Board of Nursing's advisory opinion Aesthetics Procedures & Medical Spas, first approved in January 2008, with revisions listed through 06/25. The board says an advisory opinion is not law, but is its official opinion on whether nursing procedures and practices meet Wyoming's standards of nursing practice. The statutes and administrative rules cited below are law; the opinion is the board's interpretation.

The table summarizes what each source says. The sections that follow give the conditions and limits in full.

The opinion defines a medical spa as a facility that provides cosmetic medical procedures, which may include neuromodulators, dermal fillers and non-ablative laser procedures, outside of a physician's office. Its list of covered procedures includes injectable treatment using FDA approved products, including neuromodulators such as Botox and dermal fillers.

It says a medical spa's medical director should be a licensed provider with prescriptive authority acting within their legal scope of practice: a physician, physician assistant or APRN. It says the medical director should be trained in cosmetic medical procedures, responsible for the policies and procedures and for the delegation and supervision of cosmetic procedures, responsible for all cosmetic procedures performed by staff at the spa, and responsible for making sure every staff member a procedure is delegated to is properly trained.

The opinion adds two limits that apply to every nurse. Facility policies may restrict practice further. And if a nurse does not have the education, knowledge and skills to provide care safely, the activity is not permitted, whatever the opinion says.

The opinion says it is within the scope of practice of an appropriately trained and competent nurse to perform aesthetic procedures as part of a medically prescribed plan of care, or as part of a client's personal or health maintenance care, if six conditions are met. The agency or facility has policies and procedures to guide the practice. The nurse has completed training and demonstrated continuing competency. The facility keeps documentation of each nurse's training and competency. The care is provided under the direction of a provider who has performed an initial face to face or telehealth visit. The provider is available to the RN in person or through electronic communications during the procedure. And the patient's condition is assessed before, during and after the procedure.

It says the nurse may apply written standing orders and protocols for each procedure prescribed, and that the provider does not need to be on site during treatment but shall be available.

The opinion lists what is outside the registered nurse's scope: selecting the medication, dosage, device or device setting; discussing with the patient and recommending a treatment such as Botox, or the units to administer, which it calls the practice of medicine; compounding medication (mixing or reconstituting a product according to the manufacturer's labeled directions is not compounding); and independently purchasing or obtaining the drug or equipment. In its section on registered and licensed practical nurses, it also says prescribing or dispensing FDA approved agents is not within the nurse's scope of practice, and that determining dosages is an element of prescribing.

The statute behind this is the Nurse Practice Act, which defines professional nursing to include execution of the medical regimen and says the therapeutic plan includes administering medications and treatments prescribed by any person authorized by state law to prescribe. Our guide to RN injector delegation rules compares how other states handle the same question.

The opinion says that before any medical treatment begins, the provider performs an initial, documented history and physical assessment or evaluation and develops a client-specific medical treatment plan. It says this keeps the provider involved, verifies an established client-provider relationship, and prevents the nurse from medically diagnosing, deciding that treatment is needed, or prescribing.

Under the opinion, a change to the treatment plan or the initial order requires the provider to perform and document another history and physical assessment before the change is carried out. The opinion says telehealth is acceptable for the provider's assessment.

In practice, you can ask who performed your assessment, whether it was in person or by telehealth, what the written plan says, and who will be reachable while you are treated. For how other states set the exam requirement, see our guide to good faith exam laws by state.

Wyoming's Medical Practice Act defines practicing medicine to include offering or undertaking to prescribe, order, give or administer drugs which can only be obtained by prescription, and rendering a determination of medical necessity or appropriateness of proposed treatment. The Wyoming State Board of Medicine issues the license to practice medicine under that act.

The same chapter says a physician assistant is an individual who practices medicine, and that the degree of collaboration is determined at the practice level, which may include decisions made by the employer, group, hospital service or credentialing and privileging systems. The Board of Medicine's license lookup covers both physicians and physician assistants.

The Nurse Practice Act describes an APRN as a nurse who may prescribe, administer, dispense or provide prescriptive medications (except schedule I drugs), who has completed an advanced program of study in a specialty area, passed a national certification examination in the same area and been granted licensure by the board to practice as an APRN. The Board of Nursing's practice page describes Wyoming as a full independent scope of practice state for APRNs, following the national APRN Consensus Model. Our guide to nurse practitioner independent practice explains what that means for med spas generally.

Of the Wyoming sources reviewed for this guide, the Board of Nursing's advisory opinion is the one that addresses medical spas and cosmetic injections in detail. The Board of Cosmetology's consumer page also calls Botox a medical treatment, and the Board of Medicine pages reviewed cover license lookup and complaints.

The Board of Nursing's opinion says that to perform medical aesthetic, cosmetic or dermatologic procedures, an LPN must have supervision by an on-site licensed provider with prescriptive authority, acting within their legal scope of practice, who is immediately available, and that it is not within the scope of practice of the licensed practical nurse to perform injectable aesthetic procedures. The Nurse Practice Act itself describes practical nursing as services performed under the direction of a licensed physician or dentist, APRN or registered nurse.

Wyoming's Board of Cosmetology rules (Chapter 1, effective April 1, 2026) list what the esthetics scope covers: cleansing, exfoliating, makeup and skin preparations, hair removal by means other than electrolysis and laser, brow and lash tinting and lash extensions, and facial extractions. The same section says procedures which pierce the epidermal or dermal layer of the skin are considered invasive and are prohibited, and that using the term or title of Medical Esthetician is not allowed.

The Board of Cosmetology's consumer page says it does not offer a medical esthetics license, and that treatments like Botox, laser hair removal and CoolSculpting are considered medical treatments that must be done by a licensed medical provider or under the direct supervision of a licensed medical provider in a medical office. The same page says any medical treatments offered in a salon must be done in a separate room by a licensed medical provider only, and that its licensees may not offer medical treatments in a salon unless they hold a separate medical license under the Board of Medicine or the Board of Nursing. Chapter 1 of its rules also lists, as unprofessional conduct, any act which constitutes the practice of medicine unless the licensee is also licensed or certified to perform it by another licensing board. Our guide to medical esthetician scope limits covers the same question in other states.

Physicians and physician assistants: the Board of Medicine's License Lookup page links separate searches for physicians and for physician assistants.

Nurses: the Board of Nursing's licensing page points to Nursys (nursys.com) to verify a nurse, says Wyoming does not provide paper licenses, and says a wall certificate or wallet card is not acceptable documentation for verification of a license. Estheticians and cosmetologists: the Board of Cosmetology's home page links a License Verification search.

Complaints about a physician or physician assistant go to the Board of Medicine on its complaint form, which asks for the provider's name, the facility where treatment was delivered and the dates of treatment. The form says an Authorization for Release of Medical Records must be completed and returned for the complaint to be reviewed, and it is mailed to the board at 130 Hobbs Avenue, Suite A, Cheyenne.

The Board of Nursing takes complaints through an online complaint portal. It says anyone may file, that there are no time limits on filing, and that it does not accept complaints on healthcare facilities, which the Wyoming Department of Health oversees. The Board of Cosmetology takes complaints about health, safety, infection control or non-licensed practice on a form sent to its office at 2515 Warren Avenue, Suite 302, Cheyenne. Our guides on verifying med spa credentials and filing a med spa complaint walk through the process step by step.