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Blake, McKenzie Mary

CPSO#: 90948

MEMBER STATUS

Active Member as of 04 Jan 2012

CURRENT OR PAST CPSO REGISTRATION CLASS

Independent Practice as of 04 Jan 2012

Summary

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Former Name: No Former Name

Gender: Female

Languages Spoken: English

Education: University of Ottawa, 2009

Practice Information

Primary Location of Practice

Huronia Medical Centre
Suite 200
240 Penetanguishene Road
Midland ON L4R 4P4
Phone: (705) 526-5825
Fax: (705) 526-0239 Electoral District: 05

Additional Practice Location(s)

287 Bayshore Drive
Midland ON L4R 1L3
Canada
Phone: 705-527-4151
Fax: 705-526-2870
County: County of Simcoe
Electoral District: 05

Professional Corporation Information

Corporation Name: McKenzie Blake Medicine Professional Corporation
Certificate of Authorization Status: Issued Date: Mar 30 2012

Shareholders:
Dr. M. Blake ( CPSO# 90948 )

Business Address:
Huronia Medical Centre
Suite 200, Box 790
240 Old Penetanguishene Road
Midland ON L4R 4P4
Phone Number: (705) 526-5825

Hospital Privileges

Hospital	Location
Georgian Bay General Hospital	Midland

Specialties

Specialty	Issued On	Type
Family Medicine	Effective:03 Jan 2012	CFPC Specialist

Terms and Conditions

(1) Dr. MCKENZIE MARY BLAKE may practise only in the areas of medicine in which Dr. BLAKE is educated and experienced.

Postgraduate Training

Please note: This information may not be a complete record of postgraduate training.

McMaster University, 01 Jul 2009 to 30 Jun 2010
PostGrad Yr 1 - Family Medicine

McMaster University, 01 Jul 2010 to 30 Jun 2011
PostGrad Yr 2 - Family Medicine

McMaster University, 01 Jul 2011 to 22 Dec 2011
PostGrad Yr 2 - Family Medicine

Registration History

Action	Issue Date
First certificate of registration issued: Postgraduate Education Certificate	Effective: 01 Jul 2009
Expired: Terms and conditions of certificate of registration	Expiry: 22 Dec 2011
Subsequent certificate of registration Issued: Independent Practice Certificate	Effective: 04 Jan 2012