Issue Date. 08/20/1996 Issue Dale: 08103/2009 Expiration Date: 08/19/2017 Date of Brth Born 38 years ago Gender: Melo Race: White Height. 62- Ateneon Flag: ORGAN DONOR Privacy Fag: T STORY AUSTIN CCWLES . DELRAY BEACH, FL 33445-6052 (PALM BEACH COUNTY) DLO: XXXX-XXX-XX-XXX-X Issuing State: FL Lice