| Date of birth: | Sep 30, 1957 |
| Hair: | Brown |
| Eyes: | Brown |
| Inmate number: | 00017178 |
| Booking number: | 2003006466 |
| Booking date: | Oct 15, 2003 |
| Release date: | Oct 16, 2003 |
| Booking location: | Okaloosa County, FL |
| Statute: | 893.13 - UTTERING FORGED PRESCRIPTION 10CTS |
| Offense date: | Oct 15, 2003 |
| Bond amount: | $5,000 |
| Statute: | 893.13 - OBTAIN CONTROL SUB BY FRAUD/ PROPOXYPHENE 49CTS |
| Offense date: | Oct 15, 2003 |
| Bond amount: | $5,000 |
| Statute: | DEL.9999.999 - OBTAIN PRESCRIPTION MEDICATION BY FRAUD 51CTS |
| Offense date: | Oct 15, 2003 |
| Bond amount: | $5,000 |
