| Date of birth: | 1980 |
| Unit description: | 7017 Raywood Road; Madison, WI 53713; (608)224-6310 |
| Unit: | 1 21 |
| Photo date: | Jan 19, 2011 |
| Inmate status: | ACTIVE COMMUNITY SUPERVISION |
| Booking number: | 00569692 |
| Booking location: | Polk County, WI |
| Statute: | 940.19(1) M , 968.075(1)(A) |
| County: | OUTAGAMIE |
| Convicted: | Jan 19, 2011 |
| Case number: | 09CM1308 |