Fiscal Year

2021

Case Number

A-20259-99592

Case Status

Certified

Received Date

2021-04-06

Decision Date

2021-09-09

Refile

N

Original File Date

2021-01-01 10:08:37

Previous SWA Case Number State

Schedule A Sheepherder

N

Employer Name

Lakewood Family Dental of Carmel, LLC

Employer Name Slug

lakewood-family-dental-of-carmel-llc

Employer Address 1

2330E 116th St.

Employer Address 2

Employer City

Carmel

Employer City Slug

carmel

Employer State

INDIANA

Employer State Slug

indiana

Employer Country

UNITED STATES OF AMERICA

Employer Postal Code

46032

Employer Phone

3174567869

Employer Number of Employees

4

Employer Year Commenced Business

2018

NAICS Code

621210

FW Ownership Interest

N

Employer Contact Name

Srinivasulu Kakollu

Employer Contact Address 1

2330E 116th St.

Employer Contact Address 2

Employer Contact City

Carmel

Employer Contact State/Province

INDIANA

Employer Contact Country

UNITED STATES OF AMERICA

Employer Contact Postal Code

46032

Employer Contact Phone

3174567869

Employer Contact Email

hr@lakewood-familydental.com

Agent Attorney Name

KELLIE N LEGO

Agent Attorney Firm Name

MVP LAW GROUP, PA

Agent Attorney Phone

2403900600

Agent Attorney Address 1

10632 LITTLE PATUXENT PKWY, BLDG 2000

Agent Attorney Address 2

SUITE 406

Agent Attorney City

COLUMBIA

Agent Attorney State/Province

MARYLAND

Agent Attorney Country

UNITED STATES OF AMERICA

Agent Attorney Postal Code

21044

Agent Attorney Email

KELLIE@MVPLG.COM

PW Track Number

P10020223760029

PW SOC Code

29-1021

PW SOC Title

DENTIST, GENERAL

PW Skill Level

Level I

PW Wage

84947.00

PW Unit of Pay

Year

PW Wage Source

OES

PW Determination Date

2021-01-15

PW Expiration Date

2021-06-30

Wage Offer From

84947.00

Wage Offer To

0.00

Average Salary

84947.00

Wage Unit of Pay

Year

Worksite Address 1

2330 E 116TH ST.

Worksite Address 2

Worksite City

CARMEL

Worksite City Slug

carmel

Worksite State

INDIANA

Worksite Postal Code

46032

Job Title

ASSOCIATE DENTIST

Job Title Slug

associate-dentist

Minimum Education

Other

Major Field of Study

DENTAL SURGERY, DENTAL MEDICINE

Required Training

N

Required Experience

Y

Required Experience Months

12

Accept Alternative Field of Study

N

Accept Alternative Major Field of Study

Accept Alternative Combination

N

Accept Alternative Combination Education

Accept Alternative Combination Education Years

Accept Foreign Education

Y

Accept Alternative Occupation

N

Accept Alternative Occupation Months

Accept Alternative Job Title

Job Opportunity Requirements Normal

Y

Foreign Language Required

N

Specific Skills

IN STATE DENTAL LICENSES; ANDbr KNOWLEDGE OF THE DIAGNOSIS AND TREATMENT OF ORAL AND DENTAL CONDITIONS

Combination Occupation

N

Offered to Applicant Foreign Worker

Y

Foreign Worker Live on Premises

N

Foreign Worker Live in Domestic Service

N

Foreign Worker Live in Domestic Service Count

Professional Occupation

Y

Application for College/University Teacher

N

SWA Job Order Start Date

2021-01-25

SWA Job Order End Date

2021-03-01

Sunday Edition Newspaper

Y

First Newspaper Name

INDIANAPOLIS STAR

First Advertisement Start Date

2021-01-31

Second Newspaper Ad Name

INDIANAPOLIS STAR

Second Advertisement Type

Newspaper

Second Ad Start Date

2021-02-07

Employer Website From Date

2021-01-26

Employer Website To Date

2021-02-09

Professional Organization Ad From Date

2021-01-01 10:08:37

Professional Organization Advertisement To Date

2021-01-01 10:08:37

Job Search Website From Date

2021-01-31

Job Search Website To Date

2021-02-15

Employee Referral Program From Date

2021-01-01 10:08:37

Employee Referral Program To Date

2021-01-01 10:08:37

Local Ethnic Paper From Date

2021-02-05

Local Ethnic Paper To Date

2021-02-05

Radio/TV Ad From Date

2021-01-01 10:08:37

Radio/TV Ad To Date

2021-01-01 10:08:37

Employer Received Payment

N

Posted Notice at Worksite

Y

Layoff in Past Six Months

N

Country of Citizenship

INDIA

Foreign Worker Birth Country

INDIA

Class of Admission

H-1B

Foreign Worker Education

Other

Foreign Worker Information: Major

DOCTOR OF DENTAL SURGERY

Foreign Worker Years of Education Completed

2015

Foreign Worker Institution of Education

UNIVERSITY OF CALIFORNIA, LOS ANGELES; SCHOOL OF DENTISTRY

Foreign Worker Education Institution Address 1

10833 LE CONTE AVENUE

Foreign Worker Education Institution Address 2

CHS BOX 951668

Foreign Worker Education Institution City

LOS ANGELES

Foreign Worker Education Institution State/Province

CA

Foreign Worker Education Institution Country

UNITED STATES OF AMERICA

Foreign Worker Education Institution Postal Code

90095

Foreign Worker Experience with Employer

N

Foreign Worker Employer Pays for Education

N

Foreign Worker Currently Employed

Y

Employer Completed Application

N

Preparer Name

KELLIE N LEGO

Preparer Title

ATTORNEY

Preparer Email

KELLIE@MVPLG.COM

Employer Information Declaration Name

SRINIVASULU KAKOLLU

Employer Information Declaration Title

OWNER OR DIRECTOR