| LCA CASE NUMBER | I-200-21022-027986 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-01-22 |
| DECISION DATE | 2021-01-29 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-13 |
| END DATE | 2024-07-12 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | The Board of Appleton Municipal Hospital and Nursing Home |
| TRADE NAME DBA | Appleton Area Health |
| EMPLOYER ADDRESS1 | 30 S. Behl Street |
| EMPLOYER CITY | Appleton |
| EMPLOYER STATE | MN |
| EMPLOYER POSTAL CODE | 56208 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13202898507 |
| NAICS CODE | 62211 |
| EMPLOYER POC LAST NAME | Ochsendorf |
| EMPLOYER POC FIRST NAME | Kimberly |
| EMPLOYER POC JOB TITLE | Director of Human Resources |
| EMPLOYER POC ADDRESS 1 | 30 S. Behl Street |
| EMPLOYER POC CITY | Appleton |
| EMPLOYER POC STATE | MN |
| EMPLOYER POC POSTAL CODE | 56208 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13202898507 |
| EMPLOYER POC EMAIL | kochsendorf@aah-mn.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Duong |
| AGENT ATTORNEY FIRST NAME | Hon-Vinh |
| AGENT ATTORNEY MIDDLE NAME | Quang |
| AGENT ATTORNEY ADDRESS1 | 511 Union Street |
| AGENT ATTORNEY ADDRESS2 | Suite 2700 |
| AGENT ATTORNEY CITY | Nashville |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 37219 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16158508936 |
| AGENT ATTORNEY EMAIL ADDRESS | vinh.duong@wallerlaw.com |
| LAWFIRM NAME BUSINESS NAME | Waller Lansden Dortch & Davis, LLP |
|
| STATE OF HIGHEST COURT | TN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 30 S. Behl Street |
| LCA CASE WORKLOC1 CITY | Appleton |
| WORKSITE COUNTY | SWIFT |
| LCA CASE WORKLOC1 STATE | MN |
| WORKSITE POSTAL CODE | 56208 |
| LCA CASE WAGE RATE FROM | 208000 |
| LCA CASE WAGE RATE TO | 325000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| 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 | Kang/49319 |
| PREPARER FIRST NAME | Paul |
| PREPARER BUSINESS NAME | Waller Lansden Dortch & Davis, LLP |
| PREPARER EMAIL | paul.kang@wallerlaw.com |
