| Date of birth: | Feb 9, 1956 |
| Hold: | no |
| Booking number: | 2004-012428 |
| Booking date: | May 29, 2004 |
| Release date: | Jun 13, 2004 |
| Booking location: | Polk County, FL |
| Statute: | 562.11(1) LIQUOR-SELL GIVE SERVE PERSON UNDER 21 YOA SUBSQ O |
| Charge on arrest docket: | ALC BEV SELL GIE SERVE TO PERSON |
| Charge number: | 1 |
| Statute: | 562.11(1) LIQUOR-SELL GIVE SERVE PERSON UNDER 21 YOA SUBSQ O |
| Charge on arrest docket: | ALC BEV SELL GIE SERVE TO PERSON |
| Charge number: | 2 |
