| LCA CASE NUMBER | I-200-21019-019967 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-01-19 |
| DECISION DATE | 2021-01-26 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | False |
| LCA CASE EMPLOYMENT START DATE | 2021-01-28 |
| END DATE | 2024-01-28 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| LCA CASE EMPLOYER NAME | Children's Dental Services |
| EMPLOYER ADDRESS1 | 636 Broadway ST NE |
| EMPLOYER CITY | Minneapolis |
| EMPLOYER STATE | MN |
| EMPLOYER POSTAL CODE | 55413 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16126361577 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Wovchak |
| EMPLOYER POC FIRST NAME | Sarah |
| EMPLOYER POC JOB TITLE | Executive Director |
| EMPLOYER POC ADDRESS 1 | 636 Broadway ST NE |
| EMPLOYER POC CITY | Minneapolis |
| EMPLOYER POC STATE | MN |
| EMPLOYER POC POSTAL CODE | 55413 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16126361577 |
| EMPLOYER POC EMAIL | swovcha@childrensdentalservices.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Bernhard |
| AGENT ATTORNEY FIRST NAME | Rebecca |
| AGENT ATTORNEY MIDDLE NAME | Joann |
| AGENT ATTORNEY ADDRESS1 | 50 South Sixth Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1500 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55102 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16124926186 |
| AGENT ATTORNEY EMAIL ADDRESS | bernhard.rebecca@dorsey.com |
| LAWFIRM NAME BUSINESS NAME | Dorsey & Whitney LLP |
| STATE OF HIGHEST COURT | MN |
|
| NAME OF HIGHEST STATE COURT | Supreme Court of Minnesota |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 636 Broadway ST NE |
| LCA CASE WORKLOC1 CITY | Minneapolis |
| WORKSITE COUNTY | HENNEPIN |
| LCA CASE WORKLOC1 STATE | MN |
| WORKSITE POSTAL CODE | 55413 |
| LCA CASE WAGE RATE FROM | 80 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 63.97 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | I |
| 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 BUSINESS NAME | Not Applicable |
