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
02/08/25 07:13:17 AM

General Information

Former Name: No Former Name
Medical School: Schulich School of Medicine and Dentistry, Western University, 2017
Gender: Woman
Languages Spoken: ENGLISH

Practice Information

Primary Business Location: Address not Available
Business Email: No Information Available
Phone: No Information Available
Fax: No Information Available

Specialties

SPECIALTY ISSUED ON CERTIFYING BODY
Family Medicine
Effective: 01 Jun 2022
College of Family Physicians of Canada
SPECIALTY: Family Medicine
ISSUED ON: Effective: Jun 01 2022
CERTIFYING BODY: College of Family Physicians of Canada

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: SURUJBALLI MEDICINE PROFESSIONAL CORPORATION
Certificate of Authorization Status: Inactive End Date: 11 May 2025

General Information

Former Name: No Former Name
Gender: Woman
Languages Spoken: ENGLISH
Medical School: Schulich School of Medicine and Dentistry, Western University, 2017

Practice Information

Primary Business Location: Address not Available
Business Email: No Information Available
Phone: No Information Available
Fax: No Information Available

Specialties

SPECIALTY ISSUED ON CERTIFYING BODY
Family Medicine
Effective: 01 Jun 2022
College of Family Physicians of Canada
SPECIALTY: Family Medicine
ISSUED ON: Effective: Jun 01 2022
CERTIFYING BODY: College of Family Physicians of Canada

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: SURUJBALLI MEDICINE PROFESSIONAL CORPORATION
Certificate of Authorization Status: Inactive End Date: 11 May 2025

Practice Conditions

This physician is inactive (Expired, Resigned, Suspended, Revoked, or Deceased) and is not permitted to practise medicine.
This physician is inactive (Expired, Resigned, Suspended, Revoked, or Deceased) and is not permitted to practise 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: Schulich School of Medicine and Dentistry, Western University, 2017

Registration History

DETAILS DATE
Expired: Resigned from membership. Effective: 12 Jun 2025
Subsequent certificate of registration issued: Independent Practice Certificate Effective: 16 Jun 2022
Expired: Terms and conditions of certificate of registration Effective: 06 Jun 2022
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 2017
DETAILS: Expired: Resigned from membership.
Date: Effective: 12 Jun 2025
DETAILS: Subsequent certificate of registration issued: Independent Practice Certificate
Date: Effective: 16 Jun 2022
DETAILS: Expired: Terms and conditions of certificate of registration
Date: Effective: 06 Jun 2022
DETAILS: First certificate of registration issued: Postgraduate Education Certificate
Date: Effective: 01 Jul 2017