| Date of birth: | Aug 4, 1944 |
| Hair: | White |
| Eyes: | Brown |
| Sbi number: | 000181170D |
| Facility: | Paroled from CRAF |
| Admission date: | Mar 12, 2004 |
| Booking location: | Union County, NJ |
| Discharge date: | Mar 12, 2004 |
| Offense: | 1 count of : 2C:21-4 3C*2 Fraud:Health Care Claims/2 |
| Maximum term: | 3 Years |
| County: | Union |
| Commit number: | UNN031201534A |