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
16/07/25 08:31:18 AM

General Information

Former Name: No Former Name
Medical School: University of Pretoria School of Medicine, 1996
Gender: Man
Languages Spoken: ENGLISH, AFRIKAANS

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: 08 Dec 2004
College of Family Physicians of Canada
SPECIALTY: Family Medicine
ISSUED ON: Effective: Dec 08 2004
CERTIFYING BODY: College of Family Physicians of Canada

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: Phillip Blom Medicine Professional Corporation
Certificate of Authorization Status: Inactive End Date: 09 Mar 2012

General Information

Former Name: No Former Name
Gender: Man
Languages Spoken: ENGLISH, AFRIKAANS
Medical School: University of Pretoria School of Medicine, 1996

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: 08 Dec 2004
College of Family Physicians of Canada
SPECIALTY: Family Medicine
ISSUED ON: Effective: Dec 08 2004
CERTIFYING BODY: College of Family Physicians of Canada

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: Phillip Blom Medicine Professional Corporation
Certificate of Authorization Status: Inactive End Date: 09 Mar 2012

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: University of Pretoria School of Medicine, 1996

Registration History

DETAILS DATE
Expired: Resigned from membership. Effective: 01 Jun 2013
Subsequent certificate of registration issued: Independent Practice Certificate Effective: 24 Jan 2005
Expired: Terms and conditions imposed on certificate by Registration Committee Effective: 24 Jan 2005
First certificate of registration issued: Restricted Certificate Effective: 11 Mar 2004
Arrow_iconTerms and conditions imposed on certificate by: Registration Committee Effective: 11 Mar 2004
DETAILS: Expired: Resigned from membership.
Date: Effective: 01 Jun 2013
DETAILS: Subsequent certificate of registration issued: Independent Practice Certificate
Date: Effective: 24 Jan 2005
DETAILS: Expired: Terms and conditions imposed on certificate by Registration Committee
Date: Effective: 24 Jan 2005
DETAILS: First certificate of registration issued: Restricted Certificate
Date: Effective: 11 Mar 2004
DETAILS: Terms and conditions imposed on certificate by: Registration Committee
Date: Effective: 11 Mar 2004