| Date of birth: | Apr 12, 1960 |
| Hair: | Brown |
| Eyes: | Hazel |
| Inmate number: | 00019796 |
| Booking number: | 2004004615 |
| Booking date: | Jun 30, 2004 |
| Release date: | Jul 9, 2004 |
| Booking location: | Okaloosa County, FL |
| Statute: | 322.34 - DWLSR |
| Offense date: | Jun 30, 2004 |
| Case number: | 04CT1443 |