Who Can Own a Medical Spa? [State by State Guide]

Who can own a medical spa in your state? There's no one-size-fits-all answer, but here's the bottom line: Most states require a licensed medical professional, usually a physician, but sometimes a nurse practitioner or physician assistant, to be directly involved in ownership or clinical decision-making. In some places, non-medical entrepreneurs can get in on the business, but only when they set up the right supervision and compliance.

Every state does this differently. If you want to open a med spa, you'll need to know your local rules and structure your business so you've got the right medical oversight from day one.

Here's how these laws work, the main ownership models by state, and exactly how Portrait can help you build a med spa the right way.

How Med Spa Ownership Rules Work

Med spas aren't regular salons. They're medical businesses because they do healthcare procedures. That triggers special licensing and controls who can legally own and run one.

These rules come from something called the Corporate Practice of Medicine (CPOM) doctrine. CPOM laws prevent anyone who's not medically licensed from making medical decisions or influencing care. States set their own CPOM rules and enforce them with different levels of strictness.

Here’s what you’ll usually see in the state laws:

• Some states say only doctors or physician-owned corporations can own a med spa.
• Some let nurse practitioners or physician assistants with special certifications own one.
• Others let non-physicians or entrepreneurs own the business, as long as a medical director oversees clinical care.

You need to know your state’s specific requirements and build your business around those rules. Most states fall into these three buckets:

• Physician-only ownership.
• Non-physician ownership with physician oversight.
• Mid-level provider ownership with appropriate supervision.

Who Can Own a Medical Spa in Every State

Here’s a condensed look at the rules for each state as of today. Always double-check with a healthcare attorney before you choose your setup.

Alabama

Alabama doesn't enforce CPOM. Non-physicians can own the spa but must name a licensed physician as medical director who runs clinical operations.

Alaska

Alaska needs all owners to be licensed medical providers, so CPOM applies. The medical director has to be a licensed physician.

Arizona

A physician or nurse practitioner has to own at least 51% of the spa in Arizona. Non-physicians can join with an MSO model or own a minority stake. There must be a medical director on staff.

Arkansas

Only a physician can own a med spa, but non-physicians can participate using an MSO. A doctor must be the medical director.

California

California requires a physician or physician-owned corporation with at least 51% doctor ownership. Non-physicians join via MSOs. The medical director must be a physician and stay actively involved.

Colorado

Colorado generally requires a licensed professional to own the spa. Physicians, PAs, and some nurse practitioners qualify. You need a physician as medical director.

Connecticut

Connecticut allows only physicians as owners, but MSOs let non-physicians in. The medical director can be a physician or independent nurse practitioner.

Delaware

Delaware is simple: only a physician can own a med spa. They must serve as the medical director.

Florida

Florida lets non-physicians own med spas as long as they don't control the medical side. The medical director must be a board-certified physician, often in dermatology or plastic surgery.

Georgia

Georgia doesn't enforce strict CPOM; anyone can own or run a med spa if they hire a licensed physician as medical director.

Hawaii

Only physicians can own med spas in Hawaii, and the medical director must be a doctor.

Idaho

Idaho axed its CPOM, so non-physicians can own med spas. But a doctor or physician group has to run the medical side, and a physician must be the medical director.

Illinois

CPOM is enforced in Illinois. Physicians must own, though APRNs with full practice authority can also take part. Your medical director can be a physician or an APRN with authority.

Indiana

Indiana only allows physicians as owners. Non-physicians join through an MSO. The medical director must be a doctor.

Iowa

Iowa prohibits non-physician owners. Only licensed doctors or nurse practitioners can own. The medical director (doctor or nurse practitioner) needs to be within 60 miles of the facility.

Kansas

Only physicians can own med spas in Kansas, and you need a physician as medical director.

Kentucky

Ownership is limited to state-licensed doctors or APRNs. Every med spa must have a physician as medical director who writes all the policies and procedures.

Louisiana

Anyone can own a med spa in Louisiana as long as medical oversight is in place. MSO-style models are used. The medical director must be a licensed physician.

Maine

Non-physicians can own med spas in Maine, but a licensed physician has to be the medical director.

Maryland

Only physicians can own med spas in Maryland. Non-physicians use MSOs to participate. The medical director is always a physician and must be hands-on.

Massachusetts

Only physicians or certain nurse practitioners with full authority can own here. Non-physicians use MSOs. The medical director is a physician or independent NP.

Michigan

Michigan gives you options for ownership, but you always need physician oversight. Double-check with a healthcare attorney since these rules can change.

Minnesota

Only licensed medical professionals—physicians, PAs, or APRNs—can own a med spa. A physician or independent nurse practitioner must be the medical director.

Mississippi

Physicians and non-physicians, even corporations, can own med spas in Mississippi. You always need a physician as medical director.

Missouri

Anyone can own a med spa—no CPOM. But a doctor as medical director is required.

Montana

Ownership is usually restricted to physicians and nurse practitioners with the right training. You typically need a physician medical director.

Nebraska

No CPOM doctrine here, but corporations can deliver services through licensed physicians. Physicians or NPs can own, depending on setup. A physician or independent NP must act as medical director.

Nevada

Only licensed doctors and nurse practitioners with authority can own med spas, plus advanced estheticians. There needs to be a licensed medical director involved.

New Hampshire

Anyone can own a med spa here, but must hire a medical director—either a licensed doctor or NP with full authority.

New Jersey

Only physicians can own in New Jersey. Non-physicians work through an MSO. The medical director must be a physician.

New Mexico

Anyone can own a med spa in New Mexico. All healthcare is delivered under a licensed provider's supervision, with a medical director in place.

New York

Only physicians can own New York med spas via professional entities. MSOs bring in non-physicians. The doctor owner is also the medical director and must be hands-on.

North Carolina

Ownership is just for doctors or certain physician partnerships. The medical director is always a physician and needs to be actively involved.

North Dakota

Only licensed physicians and certain NPs can own a med spa. The medical director must be a physician.

Ohio

Anyone can own a med spa in Ohio if they hire a physician as medical director. Non-physicians can’t collect profits from medical services, though.

Oklahoma

Anyone can own—but you need a medical director who's a licensed doctor supervising all treatments.

Oregon

Only physicians and certain nurse practitioners can own. Non-physician involvement happens through MSOs. Medical directors are licensed doctors or NPs and must stay hands-on with care.

Pennsylvania

Only physicians or physician groups can own a med spa. MSOs offer a path for non-physicians. Every spa must have a physician as medical director.

Rhode Island

Non-physicians can own if they get an ambulatory care facility license. Physicians can form professional corps. The medical director needs to be a physician or certified nurse practitioner with aesthetics training.

South Carolina

Non-physician ownership is allowed, but you can't interfere with a doctor’s medical decisions. You need a physician as medical director.

South Dakota

Physicians and certain NPs can own a med spa. There are exceptions that let corporations employ physicians. You'll need a medical director.

Tennessee

Only doctors or specific doctor-led partnerships can own here. MSOs for non-physicians. Your medical director has to be a doctor with an active Tennessee practice.

Texas

Physician-only in Texas. Use an MSO to get non-physicians involved. The medical director stays hands-on for all procedures.

Utah

Anyone can own a med spa in Utah. If you're not a clinician, you'll need a medical director—doctor or nurse practitioner. You must have a licensed medical pro on site for "medical spa" advertising.

Vermont

Anyone can own, but you need a doctor as medical director.

Virginia

Anyone can own a med spa here, including corporations and non-physician entrepreneurs. But you must appoint a doctor as medical director who handles all treatments and protocols and trains staff.

Washington

Ownership is open to non-doctors and corporations. Some nurse practitioners can own, too. But every med spa must have a doctor as medical director who oversees services.

West Virginia

Ownership is unclear—some say only physicians, others say anyone. You should check with an attorney, but you always need a doctor as medical director.

Wisconsin

Physician-only for ownership. Every med spa must have a doctor as medical director who writes the protocols for delegated procedures.

Wyoming

Anyone can own in Wyoming, but you must have a licensed physician as medical director for all medical services.

Why Med Spa Ownership Laws Aren't Straightforward

So why's it so complicated? Some states keep strict CPOM rules to protect physician autonomy and patient safety. Other states are more flexible to let nurse practitioners or physician assistants help expand healthcare access. Some have relaxed rules so entrepreneurs can invest in med spas as long as they stay away from medical decisions.

It doesn’t matter how flexible the state is, though. You always need a medical director. The medical director is a licensed physician. They're in charge of clinical protocols, treatment quality, and takes responsibility for patient care. The line between legal business and regulatory trouble is usually about whether you've set up medical director oversight the right way.

Some states push non-physician owners to use a Management Services Organization (MSO). Here, you handle the business stuff like marketing, billing, and staff, but an entirely separate medical group controls all clinical work. That model lets you take part in the business side legally.

Why You Need a Medical Director

No matter who owns your med spa, the medical director is the clinical backbone of your operation. This physician is both legally and clinically responsible for patient care.

What does a medical director actually handle?

• They set your clinical protocols and treatment standards.
• They check care quality and review patient charts regularly.
• They're available for consultation any time your spa is open.
• They supervise staff and manage patient outcomes.
• They manage risk, keep documentation in order, and make sure you follow all state regulations.

Medical directors are legally on the hook if med spa operations don't meet professional standards.

Medical directors also help your brand. Patients feel more confident knowing a licensed physician oversees their treatments. Regulators expect to see proper medical supervision and will look for the right documentation in audits or inspections.

Getting the right medical director is a big deal. You want someone with aesthetic medicine expertise, enough time to supervise adequately, and a willingness to be legally responsible.

How Portrait Helps Med Spa Owners

Portrait is a software platform built for med spa providers. We walk you through everything—business setup, compliance, working with medical directors, and daily clinic management. We bake in the legal compliance so you don’t miss a step.

Portrait provides medical director matching. This partners you with licensed physicians who know aesthetics and meet your state’s rules. This makes startup quick and affordable.

You also get:

• Ongoing support from healthcare legal experts. We work with law firms like ByrdAdatto to keep your clinic compliant and up to date.
• An EHR for managing scheduling, charting, payments, and inventory.
• Competitive pricing on pharmaceuticals through our partnerships.

Portrait handles the operational headaches so you can prioritize patient care and grow your clinic.

Set Your Med Spa Up for Success

Who can own a med spa comes down to your state and the right legal setup. Rules are tricky and change fast, but you should always focus on getting licensed medical oversight for every step of the process.

Don’t let the details keep you from opening your own med spa. Portrait is here to help every step of the way, including medical director matching to ensure you meeting compliance rules and maintain a high level of patient care.

Book an intro call today to learn how Portrait can help with medical director matching and beyond.