| Date of birth: | Aug 8, 1960 |
| Hair: | Brown |
| Eyes: | Brown |
| Photo date: | Jan 18, 2004 |
| Id number: | 197304 |
| Arrest date: | Jan 18, 2004 |
| Booking number: | 329449 |
| Release date: | Jan 20, 2004 |
| Booking location: | Lee County, FL |
| Type: | Felony |
| Description: | FRAUD OBTAIN CONTROLLED SUBSTANCE BY |
| Court: | Circuit Court |
| Case number: | 04-252CF |
| Agency: | CCPD |