| Date of birth: | Jan 29, 1962 |
| Obts: | 5003327930 |
| Jacket number: | 0082464 |
| Holds for other agencies: | No |
| Facility: | SURETY BOND |
| Arresting agency: | 01-PBSO |
| Booking number: | 2012019060 |
| Booking date: | May 3, 2012 |
| Release date: | May 4, 2012 |
| Booking location: | Palm Beach County, FL |
| Description: | FRAUD - CONCEAL INFO TO OBTAIN PRESCRIPTION |
| Charge number: | 893.13-3730 |
| Bond amount: | $3,000 |