Does a med spa have to register or hold a license in Mississippi?

Short answer
No — Mississippi issues no med-spa-specific license; under the medical practice act and Part 2635 a physician's office registers only for Level II or III office surgery. Other permits attach by activity — e.g., a salon license where esthetics is practiced.

Mississippi licenses the practitioner and registers the physician’s office for two things, surgery and dispensing; the sections cited here contain no medical-spa license. a physician performing Level II or Level III office surgery must register with the State Board of Medical Licensure. The rule defines surgery generally to include any operative procedure using lasers and any elective aesthetic or cosmetic procedure; how the Level II and Level III tiers themselves are drawn is not stated in the sections cited here. A physician who dispenses must obtain a certificate from the medical board after ten hours of pharmacology or dispensing education, then a dispensing physician facility permit from the Board of Pharmacy for each location at $300 a year, and must personally dispense; a physician dispenser may not offer compounded products for resale or dispense another practitioner’s or a pharmacy’s compounded product, though compounding for immediate administration is not prohibited. A pharmacy may compound patient-specific medications for office administration by a practitioner but may not offer compounded products to practitioners for resale, and a compounding pharmacy may sell a limited volume to a practitioner for office use. A cosmetology salon and each practitioner must be licensed by the cosmetology board, whose fees are set in dollars in both the statute and its rule: $50 for a practitioner, $85 for a salon application and inspection, $60 for a salon renewal. The medical board’s published schedule charges $550 for a physician or physician assistant initial license and $300 for annual renewal, the statutory ceiling; the nursing board charges $100 for the RN examination, $100 for active renewal, and $100 for controlled-substance prescriptive authority, initial or renewal.