| Date of birth: | Jul 6, 1963 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00020361 |
| Booking date: | Aug 20, 2004 |
| Release date: | Sep 29, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 893.147 - POC(AMBIEN)/POP/OBTAIN FOOD/LODGING BY FRAUD |
| Offense date: | Aug 20, 2004 |
| Case number: | 04CF1878 |