| Date of birth: | 1979 |
| Hair: | Brown |
| Eyes: | Blue |
| SO#: | 358275 |
| Booked at: | SALT LAKE |
| Cob: | Arizona |
| Citizen: | UNITED STATES |
| Booking number: | 12036517 |
| Booking date: | Jul 17, 2012 |
| Release date: | Jul 17, 2012 |
| Booking location: | Salt Lake County, UT |
| Offense date: | Jul 17, 2012 |
| Grade: | F |
| Description: | Utter/forge/alter a prescription |
| Degree: | 3 |
| Code: | 58.37.8.3.A.iii |
| Case number: | 121906442 |
| Status: | Released on own Recognizance |
| Posted: | Jul 17, 2012 |
| Number: | 121906442 |
| Amount: | $0 |
