| Date of birth: | Oct 25, 1957 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2000-017366 |
| Booking date: | Aug 22, 2000 |
| Release date: | Aug 22, 2000 |
| Booking location: | Polk County, FL |
| Statute: | 893.13(7A9) FORGERY-OBTAIN CONTROLLED SUBSTANCE BY |
| Charge on arrest docket: | ATT TO OBT PRESC BY FRAUD |
| Charge number: | 1 |
| Bond type: | SBN |
| Bond number: | X075010095 |
| Bond exp: | SBN#X07-5-01009567 1000.00 |
| Bond amount: | $1,000 |