| LCA CASE NUMBER | I-200-20062-368075 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2020-03-02 |
| DECISION DATE | 2020-09-17 |
| ORIGINAL CERT DATE | 2020-03-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Endocrinologist |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-07-01 |
| END DATE | 2023-06-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | St. Croix Regional Medical Center |
| EMPLOYER ADDRESS1 | 235 E State Street |
| EMPLOYER CITY | St. Croix Falls |
| EMPLOYER STATE | WI |
| EMPLOYER POSTAL CODE | 54024 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17154830567 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Fuge |
| EMPLOYER POC FIRST NAME | Kristine |
| EMPLOYER POC MIDDLE NAME | Nelson |
| EMPLOYER POC JOB TITLE | Chief Administrative Officer/General Counsel |
| EMPLOYER POC ADDRESS1 | 235 E State Street |
| EMPLOYER POC CITY | St. Croix Falls |
| EMPLOYER POC STATE | WI |
| EMPLOYER POC POSTAL CODE | 54024 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17154830567 |
| EMPLOYER POC EMAIL | kristine.fuge@scrmc.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Kildow |
| AGENT ATTORNEY FIRST NAME | Jeanne |
| AGENT ATTORNEY MIDDLE NAME | Glader |
| AGENT ATTORNEY ADDRESS1 | 3950 IDS Center |
| AGENT ATTORNEY ADDRESS2 | 80 South 8th Street |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16123210082.0 |
| AGENT ATTORNEY EMAIL ADDRESS | jkildow@borene.com |
| LAWFIRM NAME BUSINESS NAME | Borene Law Firm, P.A. |
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Minnesota Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 235 E State Street |
| LCA CASE WORKLOC1 CITY | St. Croix Falls |
| WORKSITE COUNTY | POLK |
| LCA CASE WORKLOC1 STATE | WI |
| WORKSITE POSTAL CODE | 54024 |
| LCA CASE WAGE RATE FROM | 208000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000.0 |
| PW UNIT OF PAY | Year |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 3 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
