| LCA CASE NUMBER | I-200-20113-507869 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-04-22 |
| DECISION DATE | 2020-04-29 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | DENTAL SERVICES MANAGER |
| SOC CODE | 11-9111.00 |
| SOC TITLE | Medical and Health Services Managers |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-09-21 |
| END DATE | 2023-09-20 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 1 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | LAKEWOOD FAMILY DENTAL, PC |
| EMPLOYER ADDRESS1 | 1407 NORTH VETERANS PARKWAY |
| EMPLOYER ADDRESS2 | SUITE 12 |
| EMPLOYER CITY | BLOOMINGTON |
| EMPLOYER STATE | IL |
| EMPLOYER POSTAL CODE | 61704 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13092333636 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | KAKOLLU |
| EMPLOYER POC FIRST NAME | SRINIVASULU |
| EMPLOYER POC JOB TITLE | DIRECTOR |
| EMPLOYER POC ADDRESS1 | 1407 NORTH VETERANS PARKWAY |
| EMPLOYER POC ADDRESS2 | SUITE 12 |
| EMPLOYER POC CITY | BLOOMINGTON |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 61704 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13092333636 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | LEGO |
| AGENT ATTORNEY FIRST NAME | KELLIE |
| AGENT ATTORNEY MIDDLE NAME | NICOLE |
| AGENT ATTORNEY ADDRESS1 | 10632 LITTLE PATUXENT PARKWAY |
| AGENT ATTORNEY ADDRESS2 | SUITE 406 |
| AGENT ATTORNEY CITY | COLUMBIA |
| AGENT ATTORNEY STATE | MD |
| AGENT ATTORNEY POSTAL CODE | 21044 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12403900600.0 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | MVP LAW GROUP PA |
| STATE OF HIGHEST COURT | MD |
| NAME OF HIGHEST STATE COURT | COURT OF APPEALS |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 1407 NORTH VETERANS PARKWAY |
| WORKSITE ADDRESS2 | #12 |
| LCA CASE WORKLOC1 CITY | BLOOMINGTON |
| WORKSITE COUNTY | MCLEAN |
| LCA CASE WORKLOC1 STATE | IL |
| WORKSITE POSTAL CODE | 61704 |
| LCA CASE WAGE RATE FROM | 88275.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 81640.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 7 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | LEGO |
| PREPARER FIRST NAME | KELLIE |
| PREPARER MIDDLE INITIAL | N |
| PREPARER BUSINESS NAME | MVP LAW GROUP PA |
| PREPARER EMAIL | [email protected] |
