| Date of birth: | 1976 |
| Unit description: | 3655 Schneider Ave SE; Menomonie, WI 54751; (715)836-6700 |
| Unit: | 5 03 |
| Pin number: | 869230 |
| Photo date: | May 6, 2011 |
| Booking number: | 00570799 |
| Booking location: | Polk County, WI |
| Statute: | UNKNOWN - IC |
| County: | OUT-OF-STATE |