| Date of birth: | Jul 9, 1972 |
| Unit description: | 5600 West Grande Market Dr, Appleton, WI 54913, (920)997-1480 |
| Unit: | 4 04 |
| Pin number: | 924207 |
| Photo date: | Jun 21, 2012 |
| Inmate status: | REVOKED |
| Booking number: | 00588915 |
| Booking location: | Outagamie County, WI |
| Statute: | 947.01 M |
| County: | OUTAGAMIE |
| Convicted: | May 21, 2012 |
| Case number: | 11CM654 |