In Utah: Cosmetic medical device" means tissue altering energy based devices that have the potential for altering living tissue and that are use to perform ablative or nonablative procedures, such as American National Standards Institute (ANSI) designated Class IIIb and Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic devices, and excludes ANSI designated Class IIIa and lower powered devices. (b) Notwithstanding Subsection (5)(a), if an ANSI designated Class IIIa and lower powered device is being used to perform an ablative procedure, the device is included in the definition of cosmetic medical device under Subsection (5)(a).
This will explain the credentials required: http://www.lasertraining.org/Administrative/Library/LaserLicensing&Credentialing0906.pdf
Be aware that as this states:
Use of Lasers by Non-Physicians:
Here we're referring to patient treatments with lasers by non-physicians - mostly with non-ablative cosmetic laser procedures. These include primarily laser hair removal and skin rejuvenation, but can also include treatment of small blood vessels (telangiectasia, spider veins, etc) or pigmented lesions (age spots, freckles, etc). It generally DOES NOT include use of ablative skin resurfacing lasers such as CO2
or Er:Yag which are much more invasive and therefore performed directly by the physician, although fractional resurfacing is much less invasive and a case can be made for its safe performance by properly trained nurses or advanced level technicians.
It is common practice to have untrained persons using these lasers but in many settings including spas, etc but according to the licensing board in most places it is not allowed.