| Date of birth: | Jul 9, 1967 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00021914 |
| Booking number: | 2005000420 |
| Booking date: | Jan 13, 2005 |
| Release date: | Jan 27, 2005 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/OBTAINING DRUGS BY FRAUD OR FORGED PRESCRIPTION |
| Offense date: | Jan 13, 2005 |
| Case number: | 04CF564C |