| Date of birth: | 1968 |
| Unit description: | 4 E. Main St; P.O. Box 427; Black River Falls, WI 54615-0066; (715)284-4747 |
| Unit: | 5 07 |
| Pin number: | 783323 |
| Photo date: | Jan 23, 2009 |
| Booking number: | 00541552 |
| Booking location: | Polk County, WI |
| Statute: | UNKNOWN - IC U |
| County: | OUT-OF-STATE |