| LCA CASE NUMBER | I-200-20142-593492 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-05-21 |
| DECISION DATE | 2020-05-29 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | 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 | CHAMPLIN DENTISTRY PC |
| TRADE NAME DBA | CHAMPLIN DENTISTRY |
| EMPLOYER ADDRESS1 | 17000 RED HILL AVENUE |
| EMPLOYER CITY | IRVINE |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 92614 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17148458596 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | BACHANI |
| EMPLOYER POC FIRST NAME | SIRAJ |
| EMPLOYER POC JOB TITLE | PRESIDENT |
| EMPLOYER POC ADDRESS1 | 17000 RED HILL AVENUE |
| EMPLOYER POC CITY | IRVINE |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 92614 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17148458596 |
| EMPLOYER POC EMAIL | KIMURAL@PACDEN.COM |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | GOLD |
| AGENT ATTORNEY FIRST NAME | DANA |
| AGENT ATTORNEY MIDDLE NAME | ANN |
| AGENT ATTORNEY ADDRESS1 | 1630 N. MAIN STREET |
| AGENT ATTORNEY ADDRESS2 | SUITE 44 |
| AGENT ATTORNEY CITY | WALNUT CREEK |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94596 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19252320442.0 |
| AGENT ATTORNEY EMAIL ADDRESS | DANA@GOLDLAWOFFICES.COM |
| LAWFIRM NAME BUSINESS NAME | GOLD LAW OFFICES |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 11231 AQUILA DRIVE N |
| LCA CASE WORKLOC1 CITY | CHAMPLIN |
| WORKSITE COUNTY | HENNEPIN |
| LCA CASE WORKLOC1 STATE | MN |
| WORKSITE POSTAL CODE | 55316 |
| LCA CASE WAGE RATE FROM | 90.0 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 88.23 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| 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 |
| PREPARER LAST NAME | SCHECHTER |
| PREPARER FIRST NAME | NIELY |
| PREPARER BUSINESS NAME | GOLD LAW OFFICES |
| PREPARER EMAIL | NIELY@GOLDLAWOFFICES.COM |
