| Date of birth: | Jun 29, 1954 |
| Hair: | Brown |
| Eyes: | Blue |
| Residency: | Resident |
| Marital status: | Single |
| Juvenile: | No |
| Employment: | 05 PROFESSIONAL |
| Employer school: | ENGLEWOOD HOSPITAL |
| Dl number: | H635113547290 |
| Citizen: | Y |
| Birth place: | MICHIGAN |
| Booking location: | Charlotte County, FL |
| Statute description: | CRIMINAL REGISTRATION |
| Statute: | CRM-1 |
| Offense date: | Jun 13, 2000 |
| Obts number: | 9037470 |
| Arrest location: | CCSO JAIL |