| LCA CASE NUMBER | I-200-20122-535465 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-05-01 |
| DECISION DATE | 2020-05-08 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | General Surgeon |
| SOC CODE | 29-1067.00 |
| SOC TITLE | Surgeons |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-07-01 |
| END DATE | 2023-07-01 |
| 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 | Advantage Health/Saint Mary's Medical Group |
| TRADE NAME DBA | Mercy Health Physician Partners |
| EMPLOYER ADDRESS1 | 245 State Street SE |
| EMPLOYER CITY | Grand Rapids |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 49503 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16166856842 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Weed |
| EMPLOYER POC FIRST NAME | Nicole |
| EMPLOYER POC JOB TITLE | Senior Physician Recruitment Coordinator |
| EMPLOYER POC ADDRESS1 | 245 State Street SE |
| EMPLOYER POC CITY | Grand Rapids |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 49503 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16166856842 |
| EMPLOYER POC EMAIL | weednk@mercyhealth.com |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | CLARKE |
| AGENT ATTORNEY FIRST NAME | KIMBERLY |
| AGENT ATTORNEY MIDDLE NAME | Ann |
| AGENT ATTORNEY ADDRESS1 | 333 BRIDGE STREET NW |
| AGENT ATTORNEY CITY | GRAND RAPIDS |
| AGENT ATTORNEY STATE | MI |
| AGENT ATTORNEY POSTAL CODE | 49504 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16163366441.0 |
| AGENT ATTORNEY EMAIL ADDRESS | kaclarke@varnumlaw.com |
| LAWFIRM NAME BUSINESS NAME | VARNUM LLP |
| STATE OF HIGHEST COURT | MI |
| NAME OF HIGHEST STATE COURT | Supreme Court of Michigan |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 72 S State Street |
| LCA CASE WORKLOC1 CITY | Shelby |
| WORKSITE COUNTY | OCEANA |
| LCA CASE WORKLOC1 STATE | MI |
| WORKSITE POSTAL CODE | 49455 |
| LCA CASE WAGE RATE FROM | 208000.0 |
| LCA CASE WAGE RATE TO | 400000.0 |
| 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 | 5 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Clarke |
| PREPARER FIRST NAME | Kimberly |
| PREPARER MIDDLE INITIAL | A |
| PREPARER BUSINESS NAME | Varnum LLP |
| PREPARER EMAIL | kaclarke@varnumlaw.com |
