THE FOLLOWING INFORMATION WAS OBTAINED FROM THE PHYSICIAN REGISTER SECTION OF THE WEBSITE OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO (WWW.CPSO.ON.CA) AS OF THE DATE AND TIME NOTED BELOW
25/04/25 23:34:14 PM

General Information

Former Name: No Former Name
Medical School: Saba University School of Medicine, 2008
Gender: Man
Languages Spoken: ENGLISH

Practice Information

Primary Business Location: 530 Tecumseh St
Dresden Ontario N0P 1M0
Business Email: No Information Available
Phone: (519) 683-4479
Fax: (519) 683-2763
Address: 180 McNaughton Ave W
Chatham Ontario N7L4Z7
Phone: 5193546400
Fax: No Information Available
Address: 80 Grand Ave
Chatham Ontario N7M5L9
Phone: (519) 352-6400
Fax: No Information Available
Address: 194 Talbot St W
Leamington Ontario N8H1N9
Phone: (519) 326-3603
Fax: No Information Available

Specialties

SPECIALTY ISSUED ON CERTIFYING BODY
Internal Medicine
Effective: 15 Dec 2014
College of Physicians and Surgeons of Ontario
SPECIALTY: Internal Medicine
ISSUED ON: Effective: Dec 15 2014
CERTIFYING BODY: College of Physicians and Surgeons of Ontario

Hospital Privileges

HOSPITAL LOCATION
Erie Shores Healthcare Leamington
Chatham-Kent Health Alliance Chatham
HOSPITAL: Erie Shores Healthcare
LOCATION: Leamington
HOSPITAL: Chatham-Kent Health Alliance
LOCATION: Chatham

Professional Corporation Information

Corporation Name: Glen K. Providence Medicine Professional Corporation
Certificate of Authorization Status: Inactive End Date: 27 Jun 2021

General Information

Former Name: No Former Name
Gender: Man
Languages Spoken: ENGLISH
Medical School: Saba University School of Medicine, 2008

Practice Information

Primary Business Location: 530 Tecumseh St
Dresden Ontario N0P 1M0
Business Email: No Information Available
Phone: (519) 683-4479
Fax: (519) 683-2763
Address: 180 McNaughton Ave W
Chatham Ontario N7L4Z7
Phone: 5193546400
Fax: No Information Available
Address: 80 Grand Ave
Chatham Ontario N7M5L9
Phone: (519) 352-6400
Fax: No Information Available
Address: 194 Talbot St W
Leamington Ontario N8H1N9
Phone: (519) 326-3603
Fax: No Information Available

Specialties

SPECIALTY ISSUED ON CERTIFYING BODY
Internal Medicine
Effective: 15 Dec 2014
College of Physicians and Surgeons of Ontario
SPECIALTY: Internal Medicine
ISSUED ON: Effective: Dec 15 2014
CERTIFYING BODY: College of Physicians and Surgeons of Ontario

Hospital Privileges

HOSPITAL LOCATION
Erie Shores Healthcare Leamington
Chatham-Kent Health Alliance Chatham
HOSPITAL: Erie Shores Healthcare
LOCATION: Leamington
HOSPITAL: Chatham-Kent Health Alliance
LOCATION: Chatham

Professional Corporation Information

Corporation Name: Glen K. Providence Medicine Professional Corporation
Certificate of Authorization Status: Inactive End Date: 27 Jun 2021

Practice Conditions

IMPOSED BY EFFECTIVE DATE EXPIRY DATE STATUS
Registration Committee
24 Jun 2016
Restricted
IMPOSED BY: Registration Committee
EFFECTIVE DATE: Jun 24 2016
EXPIRY DATE:
STATUS: Restricted
A physician who has a restricted licence must follow specific terms and conditions in their practice.
A physician who has a restricted licence must follow specific terms and conditions in their practice.
VIEW DETAILS chevron-down icon
Dr. Glen Kenneth Providence may practise medicine independently in
internal medicine.

VIEW DETAILS chevron-down icon
Dr. Glen Kenneth Providence may practise medicine independently in
internal medicine.

Current Tribunal Proceedings

No information available

Past Tribunal Proceedings

No information available

Current Tribunal Proceedings

No information available

Past Tribunal Proceedings

No information available

Training

Medical School: Saba University School of Medicine, 2008

Registration History

DETAILS DATE
Terms and conditions amended by Registration Committee. Effective: 24 Jun 2016
Terms and conditions amended by Registration Committee. Effective: 09 Jun 2016
First certificate of registration issued: Restricted Certificate Effective: 15 Dec 2014
Arrow_iconTerms and conditions imposed on certificate by: Registration Committee Effective: 15 Dec 2014
DETAILS: Terms and conditions amended by Registration Committee.
Date: Effective: 24 Jun 2016
DETAILS: Terms and conditions amended by Registration Committee.
Date: Effective: 09 Jun 2016
DETAILS: First certificate of registration issued: Restricted Certificate
Date: Effective: 15 Dec 2014
DETAILS: Terms and conditions imposed on certificate by: Registration Committee
Date: Effective: 15 Dec 2014