| LCA CASE NUMBER | I-200-19269-963043 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2019-09-26 |
| DECISION DATE | 2019-10-02 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | GENERAL DENTIST |
| SOC CODE | 29-1021 |
| SOC TITLE | DENTISTS, GENERAL |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2019-10-14 |
| END DATE | 2022-10-13 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| LCA CASE EMPLOYER NAME | FAMILIA DENTAL FORT WAYNE PLLC |
| EMPLOYER ADDRESS1 | 5328 COLDWATER ROAD |
| EMPLOYER CITY | FORT WAYNE |
| EMPLOYER STATE | IN |
| EMPLOYER POSTAL CODE | 46825 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 2604715016 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | CENDROWSKI |
| EMPLOYER POC FIRST NAME | BARBARA |
| EMPLOYER POC JOB TITLE | RECRUITMENT SPECIALIST |
| EMPLOYER POC ADDRESS1 | 2050 E. ALGONQUIN ROAD |
| EMPLOYER POC ADDRESS2 | SUITE 610 |
| EMPLOYER POC CITY | SCHAUMBURG |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 60173-6017 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 8478018365 |
| EMPLOYER POC EMAIL | BCENDROWSKI@FAMILIADENTAL.COM |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | KYLE |
| AGENT ATTORNEY FIRST NAME | KYLE |
| AGENT ATTORNEY ADDRESS1 | 301 CONGRESS AVE. |
| AGENT ATTORNEY ADDRESS2 | SUITE 1150 |
| AGENT ATTORNEY CITY | AUSTIN |
| AGENT ATTORNEY STATE | TX |
| AGENT ATTORNEY POSTAL CODE | 78701 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 5123444700.0 |
| AGENT ATTORNEY EMAIL ADDRESS | EMILY.ROWLEY@OGLETREEDEAKINS.COM |
| LAWFIRM NAME BUSINESS NAME | OGLETREE, DEAKINS, NASH, SMOAK & STEWART, P.C. |
| STATE OF HIGHEST COURT | TX |
|
| NAME OF HIGHEST STATE COURT | SUPREME COURT OF TEXAS |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 5328 COLDWATER ROAD |
| LCA CASE WORKLOC1 CITY | FORT WAYNE |
| WORKSITE COUNTY | ALLEN |
| LCA CASE WORKLOC1 STATE | IN |
| WORKSITE POSTAL CODE | 46825 |
| LCA CASE WAGE RATE FROM | 208000.0 |
| LCA CASE WAGE RATE TO | 208000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | V |
| PW OES YEAR | 2019 |
| PW OTHER SOURCE | OES |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | ROWLEY |
| PREPARER FIRST NAME | EMILY |
| PREPARER BUSINESS NAME | OGLETREE, DEAKINS, NASH, SMOAK, & STEWART P.C. |
| PREPARER EMAIL | EMILY.ROWLEY@OGLETREEDEAKINS.COM |
