ANDREW JON BOSWORTH DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

ACTIVE

Business

Title

DDS

First Name

ANDREW

Middle

JON

Last Name

BOSWORTH

Business Name

ANDREW JON BOSWORTH DDS

Original Issue Date

10/12/2016

Effective Date

08/09/2024

Expiration Date

09/30/2027

City

WAYZATA

State

Zip

55391

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/09/2024