| LCA CASE NUMBER | I-200-22059-936818 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2022-02-28 |
| DECISION DATE | 2022-03-07 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Pediatric Dentist |
| SOC CODE | 29-1029.00 |
| SOC TITLE | Dentists, All Other Specialists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-08-27 |
| END DATE | 2025-08-26 |
| 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 | Gordon & Prince Family Dentistry |
| EMPLOYER ADDRESS1 | 12723 North Bellwood Dr |
| EMPLOYER ADDRESS2 | Suite 30 |
| EMPLOYER CITY | Holland |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 49424 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16163998230 |
| NAICS CODE | 62121 |
| EMPLOYER POC LAST NAME | Gordon |
| EMPLOYER POC FIRST NAME | Daniel |
| EMPLOYER POC MIDDLE NAME | B |
| EMPLOYER POC JOB TITLE | Co-owner, Dentist |
| EMPLOYER POC ADDRESS1 | 12723 North Bellwood Dr |
| EMPLOYER POC ADDRESS2 | Suite 30 |
| EMPLOYER POC CITY | Holland |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 49424 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16163998230 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Nichols |
| AGENT ATTORNEY FIRST NAME | Samira |
| AGENT ATTORNEY MIDDLE NAME | Tehranchi |
| AGENT ATTORNEY ADDRESS1 | POBOX 9 |
| AGENT ATTORNEY CITY | Gallatin |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 37066 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16154738812 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Law office of Samira Nichols |
| STATE OF HIGHEST COURT | TN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 12723 North Bellwood Dr |
| WORKSITE ADDRESS2 | Ste 30 |
| LCA CASE WORKLOC1 CITY | Holland |
| WORKSITE COUNTY | OTTAWA |
| LCA CASE WORKLOC1 STATE | MI |
| WORKSITE POSTAL CODE | 49424 |
| LCA CASE WAGE RATE FROM | 184000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 151798 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | nichols |
| PREPARER FIRST NAME | samira |
| PREPARER BUSINESS NAME | Law Office of Samira Nichols |
| PREPARER EMAIL | [email protected] |
