Missouri's many rivers -- especially the Missouri and Mississippi Rivers -- cut through its vast, fertile plains. At their many points of confluence, settlers founded numerous counties and homesteads. Although they never intended it, their work has led to bureaucratic chaos as cities such as Kansas City, lie over multiple counties -- creating a licensing and permitting debacle. Business owners in different parts of the same city can easily need completely different sets of local licenses -- making it more difficult to wade through the regulation than to ford the state's great rivers.
In Missouri, medical Practices are among the simplest of healthcare business. However, like any facility that gives medical treatment, states and local governments care that patients get safe, clean treatment. Licenses are often required not only for practices themselves, but for medical waste disposal.