| LCA CASE NUMBER | I-200-17121-790016 |
| STATUS | CERTIFIED |
| LCA CASE SUBMIT | 5/1/2017 |
| DECISION DATE | 5/5/2017 |
| VISA CLASS | H-1B |
| LCA CASE EMPLOYMENT START DATE | 6/5/2017 |
| EMPLOYMENT END DATE | 6/5/2020 |
| LCA CASE EMPLOYER NAME | MORTENSON FAMILY DENTAL HOLDINGS, INC. |
| EMPLOYER BUSINESS DBA | MORTENSON DENTAL PARTNERS |
| EMPLOYER ADDRESS | 10300 LINN STATION ROAD |
| EMPLOYER CITY | LOUISVILLE |
| EMPLOYER STATE | KY |
| EMPLOYER POSTAL CODE | 40223 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | N/A |
| EMPLOYER PHONE | 5022548514 |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY NAME | KREBS, GLEN |
| AGENT ATTORNEY CITY | LEXINGTON |
| AGENT ATTORNEY STATE | KY |
| LCA CASE JOB TITLE | DENTIST |
| SOC CODE | 29-1021 |
| SOC NAME | DENTISTS, GENERAL |
| NAICS CODE | 621210 |
| TOTAL WORKERS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| FULL TIME POSITION | Y |
| PREVAILING WAGE | 131,186.00 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | Level II |
| PW SOURCE | Other |
| PW SOURCE YEAR | 2017 |
| PW SOURCE OTHER | OFLC ONLINE DATA CENTER |
| LCA CASE WAGE RATE FROM | 144,000.00 |
| LCA CASE WAGE RATE TO | 0.00 |
| LCA CASE WAGE RATE UNIT | Year |
| H1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| SUPPORT H1B | NA |
| LCA CASE WORKLOC1 CITY | INDEPENDENCE |
| WORKSITE COUNTY | KENTON |
| LCA CASE WORKLOC1 STATE | KY |
| WORKSITE POSTAL CODE | 41051 |
