| Date of birth: | Jan 13, 1977 |
| Unit description: | 941 Mallard Lane, #105, Balsam Lake, WI 54810, (715)485-3114 |
| Unit: | 5 08 |
| Pin number: | 892333 |
| Photo date: | Dec 22, 2011 |
| Inmate status: | REVOKED |
| Booking number: | 00579803 |
| Booking location: | Polk County, WI |
| Statute: | 346.63(1)(A) M |
| County: | POLK |
| Convicted: | Sep 16, 2011 |
| Case number: | 11CT32 |