| LCA CASE NUMBER | I-200-23126-999088 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2023-05-05 |
| DECISION DATE | 2023-05-12 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | False |
| LCA CASE EMPLOYMENT START DATE | 2023-05-23 |
| END DATE | 2026-05-22 |
| 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 | Shady Oak Dental LLC |
| TRADE NAME DBA | Shady Oak Dental |
| EMPLOYER ADDRESS1 | 208 N. Walnut Ave. |
| EMPLOYER CITY | Forreston |
| EMPLOYER STATE | IL |
| EMPLOYER POSTAL CODE | 61030 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18156564060 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Bares |
| EMPLOYER POC FIRST NAME | Kelly |
| EMPLOYER POC JOB TITLE | Owner |
| EMPLOYER POC ADDRESS1 | 208 N. Walnut Ave. |
| EMPLOYER POC CITY | Forreston |
| EMPLOYER POC STATE | IL |
| EMPLOYER POC POSTAL CODE | 61030 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18156564060 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Gonzalez Valle |
| AGENT ATTORNEY FIRST NAME | Jacqueline |
| AGENT ATTORNEY ADDRESS1 | 15925 Carmenita Rd. |
| AGENT ATTORNEY CITY | Cerritos |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 90703 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 15622291220 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Chugh, LLP. |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | True |
| SECONDARY ENTITY BUSINESS NAME | Freeport Dental |
| WORKSITE ADDRESS1 | 1450 S West Ave |
| LCA CASE WORKLOC1 CITY | Freeport |
| WORKSITE COUNTY | STEPHENSON |
| LCA CASE WORKLOC1 STATE | IL |
| WORKSITE POSTAL CODE | 61032 |
| LCA CASE WAGE RATE FROM | 58.8 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 55.91 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2022 - 6/30/2023 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H 1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Ayala |
| PREPARER FIRST NAME | Cesar |
| PREPARER BUSINESS NAME | Chugh, LLP |
| PREPARER EMAIL | [email protected] |
