| LCA CASE NUMBER | I-200-20226-768308 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2020-08-13 |
| DECISION DATE | 2022-04-08 |
| ORIGINAL CERT DATE | 2020-08-20 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | General Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-09-01 |
| END DATE | 2023-08-31 |
| 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 | Heart of Kansas Family Health Care, Inc. |
| EMPLOYER ADDRESS1 | 1905 19th Street |
| EMPLOYER CITY | Great Bend |
| EMPLOYER STATE | KS |
| EMPLOYER POSTAL CODE | 67530 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16207925700 |
| EMPLOYER PHONE EXT | 107 |
| NAICS CODE | 621498 |
| EMPLOYER POC LAST NAME | Middleton |
| EMPLOYER POC FIRST NAME | William |
| EMPLOYER POC MIDDLE NAME | Brett |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 1905 19th Street |
| EMPLOYER POC CITY | Great Bend |
| EMPLOYER POC STATE | KS |
| EMPLOYER POC POSTAL CODE | 67530 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16207925700 |
| EMPLOYER POC PHONE EXT | 107 |
| EMPLOYER POC EMAIL | bmiddleton@heartofkansas.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Kildow |
| AGENT ATTORNEY FIRST NAME | Jeanne |
| AGENT ATTORNEY ADDRESS1 | 3950 IDS Center |
| AGENT ATTORNEY ADDRESS2 | 80 South 8th Street |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16123210082 |
| AGENT ATTORNEY EMAIL ADDRESS | jkildow@borene.com |
| LAWFIRM NAME BUSINESS NAME | Borene Law Firm, P.A. |
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Minnesota Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1821 Kansas Street |
| LCA CASE WORKLOC1 CITY | Great Bend |
| WORKSITE COUNTY | BARTON |
| LCA CASE WORKLOC1 STATE | KS |
| WORKSITE POSTAL CODE | 67530 |
| LCA CASE WAGE RATE FROM | 156915 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 156915 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Kildow |
| PREPARER FIRST NAME | Jeanne |
| PREPARER BUSINESS NAME | Borene Law Firm, P.A. |
| PREPARER EMAIL | jkildow@borene.com |
