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
03/01/25 04:01:40 AM

General Information

Former Name: No Former Name
Medical School: Queen's University, 1972
Gender: Man
Languages Spoken: ENGLISH, AMERICAN SIGN LANGUAGE, 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 1974
College of Family Physicians of Canada
SPECIALTY: Family Medicine
ISSUED ON: Effective: Jul 01 1974
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, AMERICAN SIGN LANGUAGE, INDONESIAN
Medical School: Queen's University, 1972

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 1974
College of Family Physicians of Canada
SPECIALTY: Family Medicine
ISSUED ON: Effective: Jul 01 1974
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, 1972

Registration History

DETAILS DATE
Expired: Resigned from membership. Effective: 01 Jun 2015
Subsequent certificate of registration issued: Independent Practice Certificate Effective: 06 Jul 1992
Expired: Resigned from membership. Effective: 15 Jun 1981
Transfer of class of registration to: Independent Practice Certificate Effective: 02 Nov 1973
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1972
DETAILS: Expired: Resigned from membership.
Date: Effective: 01 Jun 2015
DETAILS: Subsequent certificate of registration issued: Independent Practice Certificate
Date: Effective: 06 Jul 1992
DETAILS: Expired: Resigned from membership.
Date: Effective: 15 Jun 1981
DETAILS: Transfer of class of registration to: Independent Practice Certificate
Date: Effective: 02 Nov 1973
DETAILS: First certificate of registration issued: Postgraduate Education Certificate
Date: Effective: 01 Jul 1972