| Date of birth: | 1985 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 1111080 |
| SO#: | 301070 |
| Booked at: | SALT LAKE |
| Cob: | Colorado |
| Citizen: | UNITED STATES |
| Booking number: | 11031010 |
| Booking date: | Jun 17, 2011 |
| Release date: | Jun 19, 2011 |
| Booking location: | Salt Lake County, UT |
| Offense date: | Jun 17, 2011 |
| Grade: | F |
| Description: | Utter/forge/alter a prescription |
| Degree: | 3 |
| Code: | 58.37.8.3.A.iii |
| Case number: | 101400754 |
| Status: | Sentenced |
| Number: | 101400754 |
