| Date of birth: | Mar 25, 1958 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00018875 |
| Booking number: | 2004002371 |
| Booking date: | Apr 5, 2004 |
| Release date: | Apr 13, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/DOMV BATTERY/ ST. JOHNS CO. |
| Offense date: | Apr 5, 2004 |