| Date of birth: | Aug 23, 1963 |
| Hair: | Brown |
| Eyes: | Brown |
| Number: | 00012422 |
| Booking date: | Jun 18, 2002 |
| Release date: | Jun 18, 2002 |
| Booking location: | Okaloosa County, FL |
| Statute: | 948.06 - VOP/OBTAIN DRUGS BY DEFRAUD |
| Offense date: | Jun 18, 2002 |
| Case number: | 99-1946 |
| Bond amount: | $135 |