| Date of birth: | 1947 |
| Unit description: | 4160 N Port Washington Rd; Glendale, WI 53212; (414)229-0400 |
| Unit: | 3 32 |
| Pin number: | 66763 |
| Photo date: | Aug 11, 2011 |
| Booking number: | 00015579 |
| Booking location: | Vilas County, WI |
| Statute: | 941.20(1)(A) M |
| County: | WINNEBAGO |
| Case number: | 88CM337 |