| Date of birth: | Oct 30, 1965 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00019792 |
| Booking number: | 2004004606 |
| Booking date: | Jun 30, 2004 |
| Release date: | Jun 30, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 322.34 - DWLSR |
| Offense date: | Jun 30, 2004 |
| Bond amount: | $1,000 |