N.C. Gen. Stat. » Chapter 90
NC General Statutes

N.C. Gen. Stat. § 90-18 (2026)

Practicing without license; penalties

✓ current as of July 2026
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(a) No person shall perform any act constituting the practice of medicine or surgery, as defined in this Article, or any of the branches thereof, unless the person shall have been first licensed and registered so to do in the manner provided in this Article.  Any person who practices medicine or surgery without being duly licensed and registered, as provided in this Article, shall not be allowed to maintain any action to collect any fee for such services. Any person so practicing without being duly licensed and registered in this State shall be guilty of a Class 1 misdemeanor. Any person so practicing without being duly licensed and registered in this State and who is falsely representing himself or herself in a manner as being licensed or registered under this Article or any Article of this Chapter shall be guilty of a Class I felony. Any person so practicing without being duly licensed and registered in this State and who is an out-of-state practitioner shall be guilty of a Class I felony. Any person who has a license or approval under this Article that is inactive due solely to the failure to complete annual registration in a timely fashion as required by this Article or any person who is licensed, registered, and practicing under any other Article of this Chapter shall be guilty of a Class 1 misdemeanor.

(b) Repealed by Session Laws 2007-346, s. 23, effective October 1, 2007.

(c) The following shall not constitute practicing medicine or surgery as defined in this Article:

(1) The administration of domestic or family remedies.

(2) The practice of dentistry by any legally licensed dentist engaged in the practice of dentistry and dental surgery.

(3) The practice of pharmacy by any legally licensed pharmacist engaged in the practice of pharmacy.

(3a) The provision of health care services by a licensed pharmacist under a collaborative practice agreement with one or more physicians shall be performed in accordance with rules developed by a joint subcommittee of the North Carolina Medical Board and the North Carolina Board of Pharmacy and approved by both Boards. For the purposes of this subdivision, "health care services" means medical tasks, acts, or functions authorized through a written agreement by a physician and delegated to a pharmacist for the purpose of providing drug therapy, disease, or population health management for patients.

(4) The practice of medicine and surgery by any surgeon or physician of the United States Army, Navy, or Public Health Service in the discharge of his official duties.

(5) The treatment of the sick or suffering by mental or spiritual means without the use of any drugs or other material means.

(6) The practice of optometry by any legally licensed optometrist engaged in the practice of optometry.

(7) The practice of midwifery as defined in G.S. 90-178.2.

(8) The practice of podiatric medicine and surgery by any legally licensed podiatric physician when engaged in the practice of podiatry as defined in Article 12A of this Chapter.

(9) Repealed by Session Laws 2019-191, s. 34, effective October 1, 2019.

(10) The practice of chiropractic by any legally licensed chiropractor when engaged in the practice of chiropractic as defined by law, and without the use of any drug or surgery.

(11) The practice of medicine or surgery by any nonregistered reputable physician or surgeon who comes into this State, either in person or by use of any electronic or other mediums, on an irregular basis, to consult with a resident registered physician or to consult with personnel at a medical school about educational or medical training. This proviso shall not apply to physicians resident in a neighboring state and regularly practicing in this State.

(11a) The practice of medicine or surgery by any physician who comes into this State to practice medicine or surgery so long as:

a. The physician or surgeon has an oral or written agreement with a sports team to provide general or emergency medical care to the team members, coaching staff, or families traveling with the team for a specific sporting event taking place in this State; and

b. The physician or surgeon does not provide care or consultation to any person residing in this State other than an individual described in sub-subdivision a. of this subdivision.

The exemption shall remain in force while the physician or surgeon is traveling with the team. The exemption shall not exceed 10 days per individual sporting event. However, the executive director of the Board may grant a physician or surgeon additional time for exemption of up to 20 additional days per individual sporting event.

(12) Any person practicing radiology as hereinafter defined shall be deemed to be engaged in the practice of medicine within the meaning of this Article. "Radiology" is a specialty branch of the practice of medicine in which illness or disease is diagnosed or treated using various techniques or modalities, including radiant energy or ionizing radiation, and ultrasound and magnetic resonance. The education and training for the practice of radiology includes extensive study in the physics of radiant energy and medical imaging, radiation protection, and the application of ionizing radiation in the diagnosis and treatment of disease.

(13) The performance of any medical acts, tasks, and functions by a licensed physician assistant at the direction or under the supervision of a physician in accordance with rules adopted by the Board. This subdivision shall not limit or prevent any physician from delegating to a qualified person any acts, tasks, and functions that are otherwise permitted by law or established by custom. The Board shall authorize physician assistants licensed in this State or another state to perform specific medical acts, tasks, and functions during a disaster.

(14) The practice of nursing by a registered nurse engaged in the practice of nursing and the performance of acts otherwise constituting medical practice by a registered nurse when performed in accordance with rules and regulations developed by a joint subcommittee of the North Carolina Medical Board and the Board of Nursing and adopted by both boards.

(15) The practice of dietetics/nutrition by a licensed dietitian/nutritionist under the provisions of Article 25 of this Chapter.

(16) The practice of acupuncture by a licensed acupuncturist in accordance with the provisions of Article 30 of this Chapter.

(17) The use of an automated external defibrillator as provided in G.S. 90-21.15.

(18) The practice of medicine by any nonregistered physician residing in another state or foreign country who is contacted by one of the physician's regular patients for treatment by use of any method of communication while the physician's patient is temporarily in this State.

(19) The practice of medicine or surgery by any physician who comes into this State to practice medicine or surgery at a camp that specializes in providing therapeutic recreation for individuals with chronic illnesses, as long as all the following conditions are satisfied:

a. The physician provides documentation to the medical director of the camp that the physician is licensed and in good standing to practice medicine in another state.

b. The physician provides services only at the camp or in connection with camp events or camp activities that occur off the grounds of the camp.

c. The physician receives no compensation for the services.

d. The physician provides those services within this State for no more than 30 days per calendar year.

e. The camp has a medical director who holds an unrestricted license to practice medicine and surgery issued under this Article.

(20) The provision of anesthesia services by a licensed anesthesiologist assistant under the supervision of an anesthesiologist licensed under Article 1 of this Chapter in accordance with rules adopted by the Board.  (1858-9, c. 258, s. 2; Code, s. 3122; 1885, c. 117, s. 2; c. 261; 1889, c. 181, ss. 1, 2; Rev., ss. 3645, 4502; C.S., s. 6622; 1921, c. 47, s. 7; Ex. Sess. 1921, c. 44, s. 8; 1941, c. 163; 1967, c. 263, s. 1; 1969, c. 612, s. 5; c. 929, s. 3; 1971, c. 817, s. 1; c. 1150, s. 6; 1973, c. 92, s. 1; 1983, c. 897, s. 2; 1993, c. 303, s. 2; c. 539, s. 615; 1994, Ex. Sess., c. 24, s. 14(c); 1995, c. 94, ss. 18, 19; 1997-511, s. 4; 1997-514, s. 1; 1999-290, s. 2; 2000-113, s. 2; 2001-27, s. 2; 2003-109, s. 1; 2005-415, s. 2; 2007-146, s. 3; 2007-346, s. 23; 2011-183, s. 127(b); 2011-194, s. 1; 2019-191, s. 34; 2025-37, s. 7.1(a).)

 

Notes of Decisions
Cited in 12 cases, 1948–2005 · leading case: State v. Howard, 337 S.E.2d 598 (N.C. Ct. App. 1985).
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State v. Howard, 337 S.E.2d 598 (N.C. Ct. App. 1985). · cites it 13× “A Defendants were indicted under G.S. 90-18 (1981). G.S. 90-18 provides in pertinent part: No person shall practice medicine or surgery, or any of the branches thereof, nor in any case prescribe for the cure of diseases unless he shall have been first licensed and registered so…”
Majebe v. North Carolina Bd. of Med. Examiners, 416 S.E.2d 404 (N.C. Ct. App. 1992). · cites it 12× “Majebe, regarding her possible violation of N.C. Gen. Stat. § 90-18 (1990), which prohibits the unauthorized practice of medicine.”
State v. Shaw, 289 S.E.2d 325 (N.C. 1982). · cites it 6× “See G.S. § 90-18. The practice of optometry is clearly defined in G.”
North Carolina Med. Soc'y v. North Carolina Bd. of Nursing, 610 S.E.2d 722 (N.C. Ct. App. 2005). · cites it 7× “12 , or to pursue criminal penalties pursuant to N.C. Gen. Stat. §§ 90-18 (a) and 90-21, the alleged potential injury would not be eliminated by invalidation of the position statement.”
Lenzer v. Flaherty, 418 S.E.2d 276 (N.C. Ct. App. 1992). · cites it 3× “N.C.G.S. § 90-18(13)b; N.C. Admin. Code tit.”
Deerman v. Beverly California Corp., 518 S.E.2d 804 (N.C. Ct. App. 1999). · cites it 7× “In that we have determined plaintiffs complaint adequately alleged she was discharged for complying with minimum requirements of the practice of nursing, we reject defendant’s argument that the complaint established as a matter of law the unauthorized practice of medicine by…”
State v. Loesch, 75 S.E.2d 654 (N.C. 1953). · cites it 6× “The bill of indictment follows the language of the statute and is sufficient in form to charge a violation of the provisions of G.S. 90-18. In fact, its sufficiency is not challenged except upon the ground that it fails to disclose that the Board of Medical Examiners of the…”
State v. Nelson, 317 S.E.2d 711 (N.C. Ct. App. 1984). · cites it 11× “Defendant contends that the trial court erred in failing to grant his motion to dismiss upon the grounds that G.S. 90-18 is unconstitutionally vague and overbroad.”
Nc Med. Soc. v. Nc Bd. of Nursing, 610 S.E.2d 722 (N.C. Ct. App. 2005). · cites it 7× “Petitioners' position on supervision of nursing personnel involved in anesthesia activities was set forth in the 19 November 1993 declaratory ruling regarding the scope and definition of the practice of medicine *729 pursuant to N.C. Gen.Stat. § 90-18. Respondent's position,…”
FormyDuval v. Bunn, 530 S.E.2d 96 (N.C. Ct. App. 2000). · cites it 3× “” See N.C.G.S. § 90-18 (1999) (defining the “practice of medicine” to exclude the practice of, inter alia, dentistry, pharmacy, optometry, chiropractic, and nursing); cf.”
State v. . Baker, 48 S.E.2d 61 (N.C. 1948). · cites it 2× “Whether the law in this respect should be modified in any degree is a matter for the lawmakers and not for the judges. The defendant further insists, however, that he was entitled to a judgment of nonsuit or to a directed acquittal in conformity to his prayers for instruction in…”
Allen v. Hinson, 183 S.E.2d 852 (N.C. Ct. App. 1971). “” G.S. 90-18 provides that it shall be a misdemeanor for any person to practice medicine without a license first obtained in accordance with the statutory requirements and provides further: “Any person shall be regarded as practicing medicine or surgery within the meaning of…”
— N.C. Gen. Stat. § 90-18(13) — 1 case
Lenzer v. Flaherty, 418 S.E.2d 276 (N.C. Ct. App. 1992). “N.C.G.S. § 90-18(13)b; N.C. Admin. Code tit.”
— N.C. Gen. Stat. § 90-18(14) — 1 case
Deerman v. Beverly California Corp., 518 S.E.2d 804 (N.C. Ct. App. 1999). “In that we have determined plaintiffs complaint adequately alleged she was discharged for complying with minimum requirements of the practice of nursing, we reject defendant’s argument that the complaint established as a matter of law the unauthorized practice of medicine by…”
— N.C. Gen. Stat. § 90-18(a) — 1 case
Nc Med. Soc. v. Nc Bd. of Nursing, 610 S.E.2d 722 (N.C. Ct. App. 2005). “Petitioners' position on supervision of nursing personnel involved in anesthesia activities was set forth in the 19 November 1993 declaratory ruling regarding the scope and definition of the practice of medicine *729 pursuant to N.C. Gen.Stat. § 90-18. Respondent's position,…”
— N.C. Gen. Stat. § 90-18(b) — 2 cases
North Carolina Med. Soc'y v. North Carolina Bd. of Nursing, 610 S.E.2d 722 (N.C. Ct. App. 2005). “12 , or to pursue criminal penalties pursuant to N.C. Gen. Stat. §§ 90-18 (a) and 90-21, the alleged potential injury would not be eliminated by invalidation of the position statement.”
Nc Med. Soc. v. Nc Bd. of Nursing, 610 S.E.2d 722 (N.C. Ct. App. 2005). “Petitioners' position on supervision of nursing personnel involved in anesthesia activities was set forth in the 19 November 1993 declaratory ruling regarding the scope and definition of the practice of medicine *729 pursuant to N.C. Gen.Stat. § 90-18. Respondent's position,…”
— N.C. Gen. Stat. § 90-18(c)(14) — 1 case
Deerman v. Beverly California Corp., 518 S.E.2d 804 (N.C. Ct. App. 1999). “In that we have determined plaintiffs complaint adequately alleged she was discharged for complying with minimum requirements of the practice of nursing, we reject defendant’s argument that the complaint established as a matter of law the unauthorized practice of medicine by…”
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