Alabama: who may do what, and how to check a license

The Alabama Board of Medical Examiners says it has approved a protocol that lets qualified, properly trained certified registered nurse practitioners (CRNPs) and physician assistants (PAs) give botulinum toxin for cosmetic purposes. The protocol does not allow further delegation. The Board has not authorized anyone other than a PA or CRNP under a collaboration or registration agreement to do it.

Source: NOTICE - Botox Administration/AL Board of Nursing Declaratory Ruling

Board guidance — may not be bindingChecked Sep 14, 2026

In the same 2022 IV therapy ruling, the Medical Board said a business may employ a physician to provide medical services only if the physician exercises independent medical judgment. The business and its owner may not control how physicians provide medical services. The Board said whether a business is unlawfully practicing medicine depends on the specific facts. The ruling was written about retail IV therapy businesses.

Source: Declaratory Ruling of the Alabama State Board of Medical Examiners (retail IV therapy businesses)

Board guidance — may not be bindingPublished or effective Jul 21, 2022Checked Sep 14, 2026

Under Medical Board rules, using lasers, pulsed light, or other energy or chemical treatments that affect living tissue is the practice of medicine, including for cosmetic purposes. A physician may delegate non-ablative treatments to trained delegates under written protocols, including laser hair removal and IPL. Ablative laser skin resurfacing may not be performed by Level 1 or Level 2 delegates, and physicians must register with the Board before performing these procedures.

Source: Alabama Board of Medical Examiners Administrative Code Chapter 540-X-11, Guidelines for the Use of Lasers and Other Modalities Affecting Living Tissue

Law or regulationPublished or effective Jul 15, 2023Checked Sep 14, 2026

Level 1 delegates are PAs, CRNPs, or RNs. Level 2 delegates are LPNs or medical assistants, which the rule says includes aestheticians, cosmetologists and laser technicians. Level 2 delegates may not use these devices at a remote practice site without the supervising physician on-site, and must follow training and supervised-case minimums before treating without direct physician supervision.

Source: Alabama Board of Medical Examiners Administrative Code Chapter 540-X-11 (Rules 540-X-11-.02 and 540-X-11-.08)

Law or regulationPublished or effective Jul 15, 2023Checked Sep 14, 2026

In a 2022 ruling on retail IV therapy businesses, the Medical Board said the patient must be personally evaluated and diagnosed before IV therapy is given, by a physician or by a PA, CRNP or CNM working with a physician. This may happen in person or by telemedicine, and that clinician must issue a prescription. Physician 'standing orders' for an RN to follow do not satisfy the physician's legal duties. Another licensed person may administer the IV if that is within their scope of practice.

Source: Declaratory Ruling of the Alabama State Board of Medical Examiners (retail IV therapy businesses)

Board guidance — may not be bindingPublished or effective Jul 21, 2022Checked Sep 14, 2026

Board of Cosmetology rules limit the board's scope of licensure to non-invasive services on the epidermis (the stratum corneum) that do not alter, cut or damage living cells. The rules also say licensees may not practice photo rejuvenation, permanent makeup, electrolysis, tattooing, or any other act outside the board's regulatory authority.

Source: Alabama Board of Cosmetology Administrative Code Chapter 250-X-3, Rule 250-X-3-.02 Products Sanitation And Care

Law or regulationPublished or effective Sep 1, 2017Checked Sep 14, 2026