| LCA CASE NUMBER | I-200-21118-264415 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-27 |
| DECISION DATE | 2021-05-04 |
| 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 | 2021-06-18 |
| END DATE | 2024-06-17 |
| 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 | Broadway Dentist LLC |
| EMPLOYER ADDRESS1 | 609 Broadway |
| EMPLOYER CITY | Everett |
| EMPLOYER STATE | MA |
| EMPLOYER POSTAL CODE | 2149 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16173893636 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Itkes |
| EMPLOYER POC FIRST NAME | Peter |
| EMPLOYER POC JOB TITLE | Office Manager |
| EMPLOYER POC ADDRESS 1 | 609 Broadway |
| EMPLOYER POC CITY | Everett |
| EMPLOYER POC STATE | MA |
| EMPLOYER POC POSTAL CODE | 02149 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16173893636 |
| EMPLOYER POC EMAIL | peter_itkes@yahoo.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Pan |
| AGENT ATTORNEY FIRST NAME | Yaran |
| AGENT ATTORNEY ADDRESS1 | 1661 Worcester Rd |
| AGENT ATTORNEY ADDRESS2 | Suite 103 |
| AGENT ATTORNEY CITY | Framingham |
| AGENT ATTORNEY STATE | MA |
| AGENT ATTORNEY POSTAL CODE | 1701 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 15083096685 |
| AGENT ATTORNEY EMAIL ADDRESS | yaran@panlawyer.com |
| LAWFIRM NAME BUSINESS NAME | Law Office of Yaran Pan |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 609 Broadway |
| LCA CASE WORKLOC1 CITY | Everett |
| WORKSITE COUNTY | EVERETT CITY |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 2149 |
| LCA CASE WAGE RATE FROM | 120000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 111155 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 3 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
