| CASE NUMBER | I-200-24290-411785 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/16/2024 |
| DECISION DATE | 10/23/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Physician (Colorectal Surgeon) |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 12/1/2024 |
| END DATE | 11/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Cornerstone Medical Holdings, PLC |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 43900 Garfield |
| EMPLOYER ADDRESS2 | Suite 220 |
| EMPLOYER CITY | Clinton Township |
| EMPLOYER STATE | MI |
| EMPLOYER POSTAL CODE | 48038 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15864218701 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 6211 |
| EMPLOYER POC LAST NAME | Benderoff |
| EMPLOYER POC FIRST NAME | Bruce |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS1 | 43900 Garfield |
| EMPLOYER POC ADDRESS2 | Suite 220 |
| EMPLOYER POC CITY | Clinton Township |
| EMPLOYER POC STATE | MI |
| EMPLOYER POC POSTAL CODE | 48038 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15864218701 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | dereyna@kotzsangster.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | McCarroll |
| AGENT ATTORNEY FIRST NAME | Kate |
| AGENT ATTORNEY MIDDLE NAME | M |
| AGENT ATTORNEY ADDRESS1 | 500 Woodward Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 2500 |
| AGENT ATTORNEY CITY | Detroit |
| AGENT ATTORNEY STATE | MI |
| AGENT ATTORNEY POSTAL CODE | 48226 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 13139651286 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | kmccarroll@kerr-russell.com |
| LAWFIRM NAME BUSINESS NAME | Kerr Russell & Weber, PLC |
| STATE OF HIGHEST COURT | MI |
| NAME OF HIGHEST STATE COURT | Michigan Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Ascension Macomb-Oakland Hospital |
| WORKSITE ADDRESS1 | 11800 Twelve Mile Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Warren |
| WORKSITE COUNTY | MACOMB |
| WORKSITE STATE | MI |
| WORKSITE POSTAL CODE | 48093 |
| WAGE RATE OF PAY FROM | $225,243.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $225,243.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | IV |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 9 |
| 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-12-01 |
