The immigration calendar runs through petition adjudication, visa availability under the Visa Bulletin, the immigrant-visa or adjustment step, two years of conditional residence and the removal-of-conditions decision. The clinic's construction and licensing calendar is separate, and the two intersect only at the job-creation proof.
Two calendars, one intersection
Keep the clinic calendar and the immigration calendar apart. The clinic calendar holds the lease, the build-out, equipment delivery, her state licence, the first hires and the opening date; those are commercial milestones she controls or influences. The immigration calendar holds the petition receipt date, the priority date, the month the Visa Bulletin shows it as current, the consular interview or adjustment filing, admission as a conditional resident, and the ninety-day window before the second anniversary for the removal petition.
The two meet when the payroll records from the first calendar are filed with the removal petition on the second. A clinic that opens and hires before the family is admitted is lawful, provided she is not herself working in the United States without status; many standalone investors open with a licensed associate and manage from Canada until admission. Check current processing information on the USCIS site and the monthly Visa Bulletin rather than an estimate from a seminar, and do not sell the L'Ancienne-Lorette home on the strength of a projected date.