| LCA CASE NUMBER | I-200-20273-848872 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-09-28 |
| DECISION DATE | 2020-10-05 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-10-15 |
| END DATE | 2023-10-14 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Grace Health, Inc. |
| EMPLOYER ADDRESS1 | 181 West Emmett Street |
| EMPLOYER CITY | Battle Creek |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 49037 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12699662600 |
| NAICS CODE | 6214 |
| EMPLOYER POC LAST NAME | Chang |
| EMPLOYER POC FIRST NAME | Peter |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS 1 | 181 West Emmett Street |
| EMPLOYER POC CITY | Battle Creek |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 49037 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12699662600 |
| EMPLOYER POC EMAIL | peter.chang@gracehealthmi.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Lee |
| AGENT ATTORNEY FIRST NAME | Kyung Hee |
| AGENT ATTORNEY ADDRESS1 | 3435 Wilshire Blvd |
| AGENT ATTORNEY CITY | Los Angeles |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 90010 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12133854646 |
| AGENT ATTORNEY EMAIL ADDRESS | imin@iminusa.net |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Kyung Hee Lee, P.C. |
| STATE OF HIGHEST COURT | WA |
| NAME OF HIGHEST STATE COURT | Washington Supreme Court |
| WORKSITE WORKERS | 1 |
|
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 181 West Emmett Street |
| LCA CASE WORKLOC1 CITY | Battle Creek |
| WORKSITE COUNTY | CALHOUN |
| LCA CASE WORKLOC1 STATE | MI |
| WORKSITE POSTAL CODE | 49037 |
| LCA CASE WAGE RATE FROM | 125000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 112050 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | III |
| 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 | Lee |
| PREPARER FIRST NAME | Kyung Hee |
| PREPARER BUSINESS NAME | Law Offices of Kyung Hee Lee, PC |
| PREPARER EMAIL | imin@iminusa.net |
