Does a med spa have to register or hold a license in District of Columbia?

Short answer
Yes — a corporation counts as a "person," so it may not offer a regulated health occupation unless licensed, registered, certified, or exempt; and a site offering esthetics or master esthetics also needs a shop/salon owner license for each place of business.

No person may practice, attempt to practice, or OFFER to practice a health occupation regulated under the chapter unless currently licensed, registered or certified, or exempted — and “person” is defined to include a corporation, firm, partnership, society, school or other entity, so the prohibition reaches the business as well as the individual. These claims do not create a med-spa or facility registration regime; they make offering the regulated service without a credential unlawful whoever offers it. The cosmetology rules add a PREMISES license and its price. No person may operate a salon or shop in the District without the appropriate business licenses; each salon or shop owner obtains a salon or shop license from the Board without examination, one license per place of business with the appropriate fee for each; and the Beauty and Grooming Services License issues only after the Department of Licensing and Consumer Protection has verified the professional license, compliance, payment of the fees the Director establishes, and a Certificate of Occupancy. The licensing-fee chapter prices the practitioner: a cosmetologist pays a $65.00 application fee and $110.00 for a license of up to two years, $110.00 to renew ($155.00 for managers and instructors) and $50.00 for late renewal; a barber pays the same $65.00 and $110.00, including for an owner license. The licenses the Board issues include the esthetician, the master esthetician and the shop and salon owner. On compounded drugs what is on record is DEFINITIONAL, and should be read as no more than that: the pharmacy regulations define compounding as preparation on a practitioner’s prescription drug order, or for research, teaching or analysis and not for sale or dispensing, and include preparation in anticipation of prescription orders based on routine, regularly observed prescribing patterns; a pharmacist must direct and supervise all compounding and the pharmacy must log every compounded drug; and the Health Occupations Revision Act places the compounding of drugs, as authorized by federal and District law, inside the practice of pharmacy. These claims do not survey a District rule on non-patient-specific or office-use compounded supply, and whether a compounded semaglutide or tirzepatide product may be supplied to or stocked by a med spa is not answered by them.