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

Short answer
No med spa license as such — esthetics, cosmetology, and manicuring may be done only in shops licensed by the Director, subject to the exceptions in sections 273 and 281 and Director's rules; the cited rules add no facility license for injections or lasers.

Vermont licenses the SHOP and prices it in statute. The practices of barbering, cosmetology, esthetics or manicuring are permitted only in shops licensed by the director, subject to the exceptions the chapter names; a shop is not granted a license unless it complies with the Director’s rules and has a designated licensee responsible for its overall cleanliness, sanitation and safety; and the Director issues the license to the person who owns or controls the shop once the required fee is paid. The amounts sit in the Office of Professional Regulation’s statutory fee schedule in Title 3 rather than in the cosmetology chapter: an application for licensure of a barbering or cosmetology shop is $355.00, an individual barber, cosmetologist, nail technician or esthetician application is $120.00, and biennial renewal is $285.00 for the shop and $155.00 for the individual. The chapter folds esthetics into its definition of cosmetology. These claims describe shop licensure under the cosmetology chapter; they do not address registration of a medical facility. On compounded drugs the Pharmacy chapter licenses the CHANNEL rather than the product: a drug outlet is licensed in one or more classifications that include a compounding drug outlet and an outsourcing drug outlet, each with an $800.00 initial application fee, and “practice of pharmacy” means compounding, dispensing and labeling drugs among other things. These claims do not survey the Board’s rules on non-patient-specific or office-use compounded supply, and whether a compounded semaglutide or tirzepatide product may be supplied to a med spa is not answered by them.