Most states require practitioners to have extensive training (often 2,000 to 3,000 hours) and pass standardized exams from bodies like the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).
The restriction is intended to protect public safety due to the invasive nature of the procedure. Risks of unlicensed use include: NC General Statutes - Chapter 90 Article 30 buy acupuncture needles without license
Engaging in acupuncture or advertising as a practitioner without a license is a criminal offense in many jurisdictions (e.g., a Class 1 misdemeanor in North Carolina). Most states require practitioners to have extensive training