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 13:39:56 PM

General Information

Former Name: No Former Name
Medical School: Gadjah Mada University, 1971
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

No Specialty Reported

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: Widjanarko Medicine Professional Corporation
Certificate of Authorization Status: Issued Date: 12 Apr 2006
Shareholders:
Dr. L. Widjanarko (CPSO#: 51679 ) Dr. D. Widjanarko (CPSO#: 52126 )
Business Address: Sudbury Regional Hospital
41 Ramsey Lake Road
Sudbury Ontario P3E 5J1 (705) 523-7100 Extn: 8107

General Information

Former Name: No Former Name
Gender: Man
Languages Spoken: ENGLISH, INDONESIAN
Medical School: Gadjah Mada University, 1971

Practice Information

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

Specialties

No Specialty Reported

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: Widjanarko Medicine Professional Corporation
Certificate of Authorization Status: Issued Date: 12 Apr 2006
Shareholders:
Dr. L. Widjanarko (CPSO#: 51679 ) Dr. D. Widjanarko (CPSO#: 52126 )
Business Address: Sudbury Regional Hospital
41 Ramsey Lake Road
Sudbury Ontario P3E 5J1 (705) 523-7100 Extn: 8107

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: Gadjah Mada University, 1971

Registration History

DETAILS DATE
Expired: Resigned from membership. Effective: 01 Jun 2022
Subsequent certificate of registration issued: Independent Practice Certificate Effective: 09 Jul 1984
Expired: Terms and conditions of certificate of registration Effective: 30 Jun 1983
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1978
DETAILS: Expired: Resigned from membership.
Date: Effective: 01 Jun 2022
DETAILS: Subsequent certificate of registration issued: Independent Practice Certificate
Date: Effective: 09 Jul 1984
DETAILS: Expired: Terms and conditions of certificate of registration
Date: Effective: 30 Jun 1983
DETAILS: First certificate of registration issued: Postgraduate Education Certificate
Date: Effective: 01 Jul 1978