| LCA CASE NUMBER | I-200-22151-227633 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2022-05-31 |
| DECISION DATE | 2023-06-30 |
| ORIGINAL CERT DATE | 2022-06-07 |
| 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 | 2022-10-01 |
| END DATE | 2025-09-30 |
| 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 | Clarksville Dental Center GP |
| TRADE NAME DBA | Clarksville Dental Center |
| EMPLOYER ADDRESS1 | 1301 Peachers Mill Road |
| EMPLOYER CITY | CLARKSVILLE |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37042 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19315729152 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | DeWald |
| EMPLOYER POC FIRST NAME | Ernest |
| EMPLOYER POC MIDDLE NAME | J |
| EMPLOYER POC JOB TITLE | owner |
| EMPLOYER POC ADDRESS1 | 1301 Peachers Mill Road |
| EMPLOYER POC CITY | Clarksville |
| EMPLOYER POC STATE | TN |
| EMPLOYER POC POSTAL CODE | 37042 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19318015859 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Buchanan |
| AGENT ATTORNEY FIRST NAME | Bruce |
| AGENT ATTORNEY MIDDLE NAME | E. |
| AGENT ATTORNEY ADDRESS1 | 2300 21st Ave. South |
| AGENT ATTORNEY ADDRESS2 | Suite 201 |
| AGENT ATTORNEY CITY | Nashville |
| AGENT ATTORNEY STATE | TN |
| AGENT ATTORNEY POSTAL CODE | 37212 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16153450266 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Sebelist Buchanan Law |
| STATE OF HIGHEST COURT | TN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1301 Peachers Mill Road |
| LCA CASE WORKLOC1 CITY | CLARKSVILLE |
| WORKSITE COUNTY | MONTGOMERY |
| LCA CASE WORKLOC1 STATE | TN |
| WORKSITE POSTAL CODE | 37042 |
| LCA CASE WAGE RATE FROM | 133141 |
| LCA CASE WAGE RATE TO | 133142 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 133141 |
| 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 |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Employment |
