| LCA CASE NUMBER | I-200-19276-068635 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2019-10-02 |
| DECISION DATE | 2019-10-09 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | MANAGING DENTIST |
| SOC CODE | 29-1022.00 |
| SOC TITLE | Oral and Maxillofacial Surgeons |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2019-10-07 |
| END DATE | 2022-10-06 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | KA SIMMONS DDS, PA |
| TRADE NAME DBA | AFFORDABLE CARE, LLC |
| EMPLOYER ADDRESS1 | 629 DAVIS DRIVE |
| EMPLOYER ADDRESS2 | SUITE 300 |
| EMPLOYER CITY | MORRISVILLE |
| EMPLOYER STATE | NC |
| EMPLOYER POSTAL CODE | 27560 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | +18006648212 |
| NAICS CODE | 6212 |
| EMPLOYER POC LAST NAME | FREY |
| EMPLOYER POC FIRST NAME | STEVE |
| EMPLOYER POC JOB TITLE | VP TALENT AND NETWORK DEVELOPMENT |
| EMPLOYER POC ADDRESS1 | 629 DAVIS DRIVE |
| EMPLOYER POC ADDRESS2 | SUITE 300 |
| EMPLOYER POC CITY | MORRISVILLE |
| EMPLOYER POC STATE | NC |
| EMPLOYER POC POSTAL CODE | 27560 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | +18006648212 |
| EMPLOYER POC EMAIL | SALLIE.HENRY@AFFORDABLECARE.COM |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | KIHUMBA |
| AGENT ATTORNEY FIRST NAME | BARBARA |
| AGENT ATTORNEY ADDRESS1 | 230 PEACHTREE ST. NW |
| AGENT ATTORNEY ADDRESS2 | SUITE 2400 |
| AGENT ATTORNEY CITY | ATLANTA |
| AGENT ATTORNEY STATE | GA |
| AGENT ATTORNEY POSTAL CODE | 30303 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14042306755.0 |
| AGENT ATTORNEY EMAIL ADDRESS | BKIHUMBA@CONSTANGY.COM |
| LAWFIRM NAME BUSINESS NAME | CONSTANGY, BROOKS, SMITH & PROPHETE, LLP |
| STATE OF HIGHEST COURT | GA |
| NAME OF HIGHEST STATE COURT | SUPREME COURT OF GEORGIA |
| WORKSITE WORKERS | 1.0 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 2207 SOUTH WESTERN STREET |
| WORKSITE ADDRESS2 | SUITE 40 |
| LCA CASE WORKLOC1 CITY | AMARILLO |
| WORKSITE COUNTY | POTTER |
| LCA CASE WORKLOC1 STATE | TX |
| WORKSITE POSTAL CODE | 79109 |
| LCA CASE WAGE RATE FROM | 150000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 121930.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | KIHUMBA |
| PREPARER FIRST NAME | BARBARA |
| PREPARER MIDDLE INITIAL | W |
| PREPARER BUSINESS NAME | CONSTANGY, BROOKS, SMITH & PROPHETE, LLP |
| PREPARER EMAIL | BKIHUMBA@CONSTANGY.COM |
