State Guides

Most states leave you to infer what an unacceptable directorship looks like. North Carolina’s board wrote it down, including the monthly fee.

North Carolina permits a combination most states do not — physicians together with NPs or PAs — but the entity must be owned entirely by active NC licensees.

A CRNP in Pennsylvania practices under an agreement the state holds a copy of. Which means a stale one is not a private problem.

The RN injects. The physician, CRNP or PA examines. Getting those two in the wrong order is the most common Pennsylvania finding.

Ohio is the mirror image of California: ownership is open, and the treatment room is tightly regulated. Operators celebrate the first half and get caught by the second.

Fifteen observed, twenty performed, per device type, with the physician in the same room for the twenty. Do that arithmetic before you buy the second laser.

One clause in WAC 246-919-606 quietly disqualifies the absentee medical director: you cannot delegate a procedure you were never trained to perform.

Washington splits the IV into two acts: placing the line and administering the drug. A medical assistant-certified can do one of them without a practitioner watching.

Georgia has no med spa license and no state registry, which makes it look easy. Then you hire a fifth nurse practitioner and discover the statute that decides your growth plan.

Arizona grants nurse practitioners full practice authority. An NP can own the clinic, prescribe, and be their own clinical lead. Here is what that changes, and the four times you still want a physician.

Illinois owners budget for the corporate practice of medicine and then get sued over a facial-analysis camera. BIPA is the only statute of its kind in the country, and a med spa is a near-perfect defendant.

Since 2016 Tennessee has maintained a public online registry of medical spas listing the supervising physician and their license number. That one design choice changes the whole directorship calculus.