| LCA CASE NUMBER | I-200-20108-494601 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-04-16 |
| DECISION DATE | 2020-04-23 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Associate General Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-10-01 |
| END DATE | 2023-09-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Pawel R. Bielecki, D.D.S.,P.C. |
| TRADE NAME DBA | Young at Heart Dentistry |
| EMPLOYER ADDRESS1 | 2603 Vinewood Lane |
| EMPLOYER CITY | Pueblo |
| EMPLOYER STATE | CO |
| EMPLOYER POSTAL CODE | 81005 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17196969009 |
| NAICS CODE | 6212 |
| EMPLOYER POC LAST NAME | Constuble |
| EMPLOYER POC FIRST NAME | Renee |
| EMPLOYER POC JOB TITLE | Business Manager |
| EMPLOYER POC ADDRESS1 | 2603 Vinewood Lane |
| EMPLOYER POC CITY | Pueblo |
| EMPLOYER POC STATE | CO |
| EMPLOYER POC POSTAL CODE | 81005 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17196969009 |
| EMPLOYER POC EMAIL | rconstuble@hotmail.com |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Rudinsky |
| AGENT ATTORNEY FIRST NAME | Agnes |
| AGENT ATTORNEY MIDDLE NAME | Cha |
| AGENT ATTORNEY ADDRESS1 | 1750 Tysons Boulevard, Suite 1000 |
| AGENT ATTORNEY CITY | McLean |
| AGENT ATTORNEY STATE | VA |
| AGENT ATTORNEY POSTAL CODE | 22102 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17037491378.0 |
| AGENT ATTORNEY EMAIL ADDRESS | rudinskya@gtlaw.com |
| LAWFIRM NAME BUSINESS NAME | Greenberg Traurig, LLP |
| STATE OF HIGHEST COURT | IL |
| NAME OF HIGHEST STATE COURT | Illinois Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 2603 Vinewood Ln. |
| LCA CASE WORKLOC1 CITY | Pueblo |
| WORKSITE COUNTY | PUEBLO |
| LCA CASE WORKLOC1 STATE | CO |
| WORKSITE POSTAL CODE | 81005 |
| LCA CASE WAGE RATE FROM | 155000.0 |
| LCA CASE WAGE RATE TO | 200000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 136656.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Rudinsky |
| PREPARER FIRST NAME | Agnes |
| PREPARER BUSINESS NAME | Greenberg Traurig, LLP |
| PREPARER EMAIL | rudinskya@gtlaw.com |
