| LCA CASE NUMBER | I-200-21294-660539 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2021-10-21 |
| DECISION DATE | 2022-10-26 |
| ORIGINAL CERT DATE | 2021-10-28 |
| 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 | 2021-10-25 |
| END DATE | 2024-10-24 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Midwest Dental of Illinois, LLC |
| EMPLOYER ADDRESS1 | 100 Spectrum Center Drive |
| EMPLOYER ADDRESS2 | Suite 1500 |
| EMPLOYER CITY | Irvine |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 92618 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19494228378 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Armenta |
| EMPLOYER POC FIRST NAME | Kristin |
| EMPLOYER POC JOB TITLE | Sr. Manager, Recruitment Operations |
| EMPLOYER POC ADDRESS1 | 100 Spectrum Center Drive |
| EMPLOYER POC ADDRESS2 | Suite 1500 |
| EMPLOYER POC CITY | Irvine |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 92618 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17144281379 |
| EMPLOYER POC EMAIL | Kristin.Armenta@smilebrands.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Wu |
| AGENT ATTORNEY FIRST NAME | Tiffany |
| AGENT ATTORNEY MIDDLE NAME | Chang |
| AGENT ATTORNEY ADDRESS1 | 18401 Von Karman Ave. |
| AGENT ATTORNEY ADDRESS2 | Suite 255 |
| AGENT ATTORNEY CITY | Irvine |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 92612 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19492610209 |
|
| AGENT ATTORNEY EMAIL ADDRESS | efinch@fragomen.com |
| LAWFIRM NAME BUSINESS NAME | Fragomen, Del Rey, Bernsen & Loewy, LLP |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 3212 Court Street |
| LCA CASE WORKLOC1 CITY | Pekin |
| WORKSITE COUNTY | TAZEWELL |
| LCA CASE WORKLOC1 STATE | IL |
| WORKSITE POSTAL CODE | 61554 |
| LCA CASE WAGE RATE FROM | 100 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 100 |
| PW UNIT OF PAY | Hour |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Wu |
| PREPARER FIRST NAME | Tiffany |
| PREPARER MIDDLE INITIAL | C |
| PREPARER BUSINESS NAME | Fragomen, Del Rey, Bernsen & Loewy, LLP |
| PREPARER EMAIL | efinch@fragomen.com |
