| LCA CASE NUMBER | I-200-20132-561289 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2020-05-11 |
| DECISION DATE | 2021-12-20 |
| ORIGINAL CERT DATE | 2020-05-18 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist-Periodontist |
| SOC CODE | 29-1029.00 |
| SOC TITLE | Dentists, All Other Specialists |
| FULL TIME POSITION | True |
| 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 | Dental Associates Ltd. of Wisconsin |
| EMPLOYER ADDRESS1 | 205 E. Wisconsin Avenue |
| EMPLOYER CITY | Milwaukee |
| EMPLOYER STATE | WI |
| EMPLOYER POSTAL CODE | 53202 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19204311712 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Kabara |
| EMPLOYER POC FIRST NAME | Karla |
| EMPLOYER POC JOB TITLE | Director of Operations |
| EMPLOYER POC ADDRESS1 | 2340 Duck Creek Parkway |
| EMPLOYER POC CITY | Green Bay |
| EMPLOYER POC STATE | WI |
| EMPLOYER POC POSTAL CODE | 54303 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19204311712 |
| EMPLOYER POC EMAIL | kkabara@dentalassociates.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Rourke |
| AGENT ATTORNEY FIRST NAME | Kelly |
| AGENT ATTORNEY MIDDLE NAME | R |
| AGENT ATTORNEY ADDRESS1 | 790 N. Water Street |
| AGENT ATTORNEY ADDRESS2 | Suite 2500 |
| AGENT ATTORNEY CITY | Milwaukee |
| AGENT ATTORNEY STATE | WI |
| AGENT ATTORNEY POSTAL CODE | 53202 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14142716560 |
| AGENT ATTORNEY EMAIL ADDRESS | krrourke@michaelbest.com |
| LAWFIRM NAME BUSINESS NAME | Michael Best & Friedrich LLP |
| STATE OF HIGHEST COURT | WI |
| NAME OF HIGHEST STATE COURT | Wisconsin Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 545 E. Johnson Street |
| LCA CASE WORKLOC1 CITY | Fond du Lac |
| WORKSITE COUNTY | FOND DU LAC |
| LCA CASE WORKLOC1 STATE | WI |
| WORKSITE POSTAL CODE | 54935 |
| LCA CASE WAGE RATE FROM | 126610 |
| LCA CASE WAGE RATE TO | 200000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 121576 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Gardner |
| PREPARER FIRST NAME | Heather |
| PREPARER MIDDLE INITIAL | L |
| PREPARER BUSINESS NAME | Michael Best & Friedrich LLP |
| PREPARER EMAIL | hlgardner@michaelbest.com |
