| Date of birth: | 1969 |
| Unit description: | 2700 College Drive; P.O. Box 68; Rice Lake, WI 54868-0068; (715)234-6925 |
| Unit: | 5 04 |
| Pin number: | 881176 |
| Photo date: | Aug 3, 2011 |
| Inmate status: | ACTIVE COMMUNITY SUPERVISION |
| Booking number: | 00575659 |
| Booking location: | Polk County, WI |
| Statute: | 940.19(1) M , 947.01 M |
| County: | WASHBURN |
| Convicted: | Jun 29, 2011 |
| Case number: | 09CF75 |