| LCA CASE NUMBER | I-200-21294-659822 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2021-10-21 |
| DECISION DATE | 2022-02-24 |
| 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 | 2021-11-01 |
| END DATE | 2024-10-31 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Sullivan County Oral Health Collaborative, Inc. |
| TRADE NAME DBA | Community Dental Care Claremont |
| EMPLOYER ADDRESS1 | 1 Tremont St |
| EMPLOYER CITY | Claremont |
| EMPLOYER STATE | NH |
| EMPLOYER POSTAL CODE | 03743 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16032871300 |
| NAICS CODE | 621210 |
| EMPLOYER POC LAST NAME | Bouchard |
| EMPLOYER POC FIRST NAME | Sally |
| EMPLOYER POC MIDDLE NAME | J. |
| EMPLOYER POC JOB TITLE | Executive Director |
| EMPLOYER POC ADDRESS1 | 1 Tremont St. |
| EMPLOYER POC CITY | Claremont |
| EMPLOYER POC STATE | NH |
| EMPLOYER POC POSTAL CODE | 03743 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16032871300 |
| EMPLOYER POC EMAIL | cdcc@comcast.net |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | White |
| AGENT ATTORNEY FIRST NAME | Emily |
| AGENT ATTORNEY MIDDLE NAME | Assunta |
| AGENT ATTORNEY ADDRESS1 | 180 Bridge Street |
| AGENT ATTORNEY CITY | Manchester |
| AGENT ATTORNEY STATE | NH |
| AGENT ATTORNEY POSTAL CODE | 03104 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16037928472 |
| AGENT ATTORNEY EMAIL ADDRESS | ewhite@shaheengordon.com |
| LAWFIRM NAME BUSINESS NAME | Shaheen & Gordon, P.A. |
| STATE OF HIGHEST COURT | NH |
| NAME OF HIGHEST STATE COURT | New Hampshire Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1 Tremont St |
| LCA CASE WORKLOC1 CITY | Claremont |
| WORKSITE COUNTY | CONCORD CITY |
| LCA CASE WORKLOC1 STATE | NH |
| WORKSITE POSTAL CODE | 03743 |
| LCA CASE WAGE RATE FROM | 160659 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 160659 |
| 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 | Lovgren |
| PREPARER FIRST NAME | Lindsey |
| PREPARER MIDDLE INITIAL | S. |
| PREPARER BUSINESS NAME | Shaheen & Gordon, PA |
| PREPARER EMAIL | llovgren@shaheengordon.com |