| LCA CASE NUMBER | I-200-21174-421185 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-23 |
| DECISION DATE | 2021-06-30 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-11-01 |
| END DATE | 2024-06-30 |
| 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 | Hannibal Regional Healthcare System, Inc. |
| EMPLOYER ADDRESS1 | 6500 Hospital Drive |
| EMPLOYER CITY | Hannibal |
| EMPLOYER STATE | MO |
| EMPLOYER POSTAL CODE | 63401 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15734061606 |
| NAICS CODE | 621112 |
| EMPLOYER POC LAST NAME | Wathen |
| EMPLOYER POC FIRST NAME | Susan |
| EMPLOYER POC MIDDLE NAME | R. |
| EMPLOYER POC JOB TITLE | VP, Human Resources |
| EMPLOYER POC ADDRESS 1 | 6500 Hospital Drive |
| EMPLOYER POC CITY | Hannibal |
| EMPLOYER POC STATE | MO |
| EMPLOYER POC POSTAL CODE | 63401 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15734061606 |
| EMPLOYER POC EMAIL | susan.wathen@hrhonline.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Webber |
| AGENT ATTORNEY FIRST NAME | Robert |
| AGENT ATTORNEY ADDRESS1 | 50 South Sixth Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1500 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16124926715 |
| AGENT ATTORNEY EMAIL ADDRESS | webber.robert@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 | 6500 Hospital Drive |
| LCA CASE WORKLOC1 CITY | Hannibal |
| WORKSITE COUNTY | MARION |
| LCA CASE WORKLOC1 STATE | MO |
| WORKSITE POSTAL CODE | 63401 |
| LCA CASE WAGE RATE FROM | 112050 |
| LCA CASE WAGE RATE TO | 300000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 112050 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | IV |
| 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 | Benson |
| PREPARER FIRST NAME | Jillian |
| PREPARER BUSINESS NAME | Dorsey & Whitney LLP |
| PREPARER EMAIL | benson.jillian@dorsey.com |
