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
07/11/24 12:57:57 PM

General Information

Former Name: No Former Name
Medical School: Queen's University, 1956
Gender: Man
Languages Spoken: ENGLISH, INDONESIAN

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 Jul 1981
College of Family Physicians of Canada
SPECIALTY: Family Medicine
ISSUED ON: Effective: Jul 01 1981
CERTIFYING BODY: College of Family Physicians of Canada

Hospital Privileges

No information available

General Information

Former Name: No Former Name
Gender: Man
Languages Spoken: ENGLISH, INDONESIAN
Medical School: Queen's University, 1956

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 Jul 1981
College of Family Physicians of Canada
SPECIALTY: Family Medicine
ISSUED ON: Effective: Jul 01 1981
CERTIFYING BODY: College of Family Physicians of Canada

Hospital Privileges

No information available

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: Queen's University, 1956

Registration History

DETAILS DATE
Expired: Resigned from membership. Effective: 01 Jun 2005
Subsequent certificate of registration issued: Independent Practice Certificate Effective: 12 Jul 1973
Expired: Resigned from membership. Effective: 23 Jun 1970
Subsequent certificate of registration issued: Independent Practice Certificate Effective: 06 Aug 1968
Expired: Resigned from membership. Effective: 18 Dec 1964
First certificate of registration issued: Independent Practice Certificate Effective: 14 Jun 1957

DETAILS: Expired: Resigned from membership.
Date: Effective: 01 Jun 2005


DETAILS: Subsequent certificate of registration issued: Independent Practice Certificate
Date: Effective: 12 Jul 1973

DETAILS: Expired: Resigned from membership.
Date: Effective: 23 Jun 1970

DETAILS: Subsequent certificate of registration issued: Independent Practice Certificate
Date: Effective: 06 Aug 1968

DETAILS: Expired: Resigned from membership.
Date: Effective: 18 Dec 1964

DETAILS: First certificate of registration issued: Independent Practice Certificate
Date: Effective: 14 Jun 1957