| CASE NUMBER | I-200-24065-773482 |
| CASE STATUS | Certified - Withdraw |
| RECEIVED DATE | 3/5/2024 |
| DECISION DATE | 8/6/2024 |
| ORIGINAL CERT DATE | 3/12/2024 |
| VISA CLASS | H-1B |
| JOB TITLE | OB/GYN Physician |
| SOC CODE | 29-1218 |
| SOC TITLE | Obstetricians and Gynecologists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 8/1/2024 |
| END DATE | 7/31/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | MidMichigan Obstetrics and Gynecology, P.C. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 3016 West Wackerly Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Midland |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 48640 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +19896316730 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Thiele |
| EMPLOYER POC FIRST NAME | Scott |
| EMPLOYER POC MIDDLE NAME | A. |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS1 | 3016 West Wackerly Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Midland |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 48640 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +19896316730 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | sthiele1@me.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Hitz |
| AGENT ATTORNEY FIRST NAME | Alison |
| AGENT ATTORNEY MIDDLE NAME | P. |
| AGENT ATTORNEY ADDRESS1 | 505 Montgomery Street |
| AGENT ATTORNEY ADDRESS2 | Flr. 13th |
| AGENT ATTORNEY CITY | San Francisco |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 94111 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +14159848563 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | ahitz@ClarkHill.com |
| LAWFIRM NAME BUSINESS NAME | Clark Hill PLC |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 3016 West Wackerly Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Midland |
| WORKSITE COUNTY | MIDLAND |
| WORKSITE STATE | MI |
| WORKSITE POSTAL CODE | 48640 |
| WAGE RATE OF PAY FROM | 280,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $161,803.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Hitz |
| PREPARER FIRST NAME | Alison |
| PREPARER MIDDLE INITIAL | P. |
| PREPARER BUSINESS NAME | Clark Hill PLC |
| PREPARER EMAIL | ahitz@ClarkHill.com |
| BEGIN DATE CONVERTED | 2024-01-08 |
