| LCA CASE NUMBER | I-200-21160-382810 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-09 |
| DECISION DATE | 2021-06-16 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Hospitalist |
| SOC CODE | 29-1069 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-11-11 |
| END DATE | 2024-11-10 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | St. Croix Regional Medical Center |
| EMPLOYER ADDRESS1 | 235 State Street |
| EMPLOYER CITY | St. Croix Falls |
| EMPLOYER STATE | WI |
| EMPLOYER POSTAL CODE | 54024 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17154830233 |
| NAICS CODE | 621491 |
| EMPLOYER POC LAST NAME | Dobosenski |
| EMPLOYER POC FIRST NAME | Dave |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS 1 | 235 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 | 17154830233 |
| EMPLOYER POC EMAIL | dave.dobosenski@scrmc.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Gotcher |
| AGENT ATTORNEY FIRST NAME | James |
| AGENT ATTORNEY MIDDLE NAME | K |
| AGENT ATTORNEY ADDRESS1 | 30300 Agoura Road |
| AGENT ATTORNEY ADDRESS2 | Ste. B100 |
| AGENT ATTORNEY CITY | Agoura Hills |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 91301 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18189146482 |
| AGENT ATTORNEY EMAIL ADDRESS | Admin@gip-us.com |
| LAWFIRM NAME BUSINESS NAME | Global Immigration Partners, Inc |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | Hudson Hospital, Inc. |
| WORKSITE ADDRESS1 | 405 Stageline Rd |
| LCA CASE WORKLOC1 CITY | Hudson |
| WORKSITE COUNTY | ST CROIX |
| LCA CASE WORKLOC1 STATE | WI |
| WORKSITE POSTAL CODE | 54016 |
| LCA CASE WAGE RATE FROM | 280000 |
| LCA CASE WAGE RATE TO | 330000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 4 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Gotcher |
| PREPARER FIRST NAME | James |
| PREPARER MIDDLE INITIAL | K |
| PREPARER BUSINESS NAME | Global Immigration Partners, Inc |
| PREPARER EMAIL | Admin@gip-us.com |
