| Document Date: 2011-11-04 18:03:37
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City WINNIPEG / / Company MEDICAL CORPORATION / PRACTISE AS PROFESSIONAL CORPORATION / / Country Canada / / Facility The College of Physicians / / / Organization College of Physicians & Surgeons / College of Physicians & Surgeons of Manitoba / / Person Relationship / / / Position PHYSICIAN / President / director / officer / Director / CORPORATE SIGNING OFFICER / licensed member / director of the corporation / / ProvinceOrState Manitoba / /
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[removed]PORTAGE AVENUE WINNIPEG, MANITOBA R3J 3T7 TEL: ([removed]FAX: ([removed]VIA WEB) APPLICATION FOR LICENCE TO PRACTISE AS PROFESSIONAL CORPORATION