| LCA CASE NUMBER | I-200-20129-554984 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-05-08 |
| DECISION DATE | 2020-05-15 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | 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 | Isam Ibrahim, D.D.S. & Associates (Eastwood Mall/Niles), Inc. |
| EMPLOYER ADDRESS1 | 5555 Youngstown Warren Road |
| EMPLOYER ADDRESS2 | Suite 908 |
| EMPLOYER CITY | Niles |
| EMPLOYER STATE | OH |
| EMPLOYER POSTAL CODE | 44446 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13306520808 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Ibrahim |
| EMPLOYER POC FIRST NAME | Isam |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS1 | 5555 Youngstown Warren Road |
| EMPLOYER POC ADDRESS2 | Suite 908 |
| EMPLOYER POC CITY | Niles |
| EMPLOYER POC STATE | OH |
| EMPLOYER POC POSTAL CODE | 44446 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13306520808 |
| EMPLOYER POC EMAIL | sammays06@verizon.net |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Coenen |
| AGENT ATTORNEY FIRST NAME | Nicholas |
| AGENT ATTORNEY MIDDLE NAME | J |
| AGENT ATTORNEY ADDRESS1 | 332 S Michigan Ave |
| AGENT ATTORNEY ADDRESS2 | Suite 1428 |
| AGENT ATTORNEY CITY | Chicago |
| AGENT ATTORNEY STATE | IL |
| AGENT ATTORNEY POSTAL CODE | 60604 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13123419730.0 |
| AGENT ATTORNEY EMAIL ADDRESS | nicholasjc@klc-ltd.com |
| LAWFIRM NAME BUSINESS NAME | Kempster, Corcoran, Quiceno & Lenz-Calvo, LTD |
| STATE OF HIGHEST COURT | IL |
| NAME OF HIGHEST STATE COURT | Illinois Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 5555 Youngstown Warren Rd |
| WORKSITE ADDRESS2 | Suite 908 |
| LCA CASE WORKLOC1 CITY | Niles |
| WORKSITE COUNTY | TRUMBULL |
| LCA CASE WORKLOC1 STATE | OH |
| WORKSITE POSTAL CODE | 44446 |
| LCA CASE WAGE RATE FROM | 115128.0 |
| LCA CASE WAGE RATE TO | 143813.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 115128.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
