| LCA CASE NUMBER | I-200-21145-341328 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-05-25 |
| DECISION DATE | 2021-06-02 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | DENTIST, GENERAL |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-21 |
| END DATE | 2024-07-20 |
| 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 | CRUSADERS CENTRAL CLINIC ASSOCIATION |
| TRADE NAME DBA | CRUSADER COMMUNITY HEALTH |
| EMPLOYER ADDRESS1 | 1200 WEST STATE STREET |
| EMPLOYER CITY | ROCKFORD |
| EMPLOYER STATE | IL |
| EMPLOYER POSTAL CODE | 61102 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18154901616 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | DAVENPORT |
| EMPLOYER POC FIRST NAME | PEGGYANNE |
| EMPLOYER POC MIDDLE NAME | W. |
| EMPLOYER POC JOB TITLE | EXECUTIVE ASSISTANT |
| EMPLOYER POC ADDRESS 1 | 1200 WEST STATE STREET |
| EMPLOYER POC CITY | ROCKFORD |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 61102 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18154901616 |
| EMPLOYER POC EMAIL | PDAVENPORT@CRUSADERHEALTH.ORG |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | PEDERSON |
| AGENT ATTORNEY FIRST NAME | JAN |
| AGENT ATTORNEY MIDDLE NAME | M. |
| AGENT ATTORNEY ADDRESS1 | 6931Arlington Road, Suite 450 |
| AGENT ATTORNEY CITY | BETHESDA |
| AGENT ATTORNEY STATE | MD |
| AGENT ATTORNEY POSTAL CODE | 20814 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12022564989 |
| AGENT ATTORNEY EMAIL ADDRESS | jan@wcslaw.com |
| LAWFIRM NAME BUSINESS NAME | Wright, Constable & Skeen, LLP |
|
| STATE OF HIGHEST COURT | DC |
| NAME OF HIGHEST STATE COURT | DC COURT OF APPEALS |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1200 W State St |
| LCA CASE WORKLOC1 CITY | Rockford |
| WORKSITE COUNTY | WINNEBAGO |
| LCA CASE WORKLOC1 STATE | IL |
| WORKSITE POSTAL CODE | 61102 |
| LCA CASE WAGE RATE FROM | 128865 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 52520 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 7 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
