New | Create a Professional Account

Create a Professional Account

You will require to upload an aesthetic or medical professional license during the registration. Required documents must be authentic. Make sure all your information is spelled correctly.
First Name*
First Name
Last Name*
Last Name
Email*
example@example.com
State*
Phone Number*
Please enter a valid phone number.
Cell Phone Number*
Please enter a valid cell phone number.
Professional license upload*

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Please attach a copy of your aesthetic professional license or a medical professional license*

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Please attach a copy of your resellers permit if you have one

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Can you describe what solutions and products are you most interested in?*
Do you agree to receive e-mail and/or SMS marketing from XTETIC World, Inc?*

YesNo
Account Form
Status
License File
INPROGRESS Email
Ressellers Permit?
Should be Empty: