| Date of birth: | Feb 11, 1928 |
| Obts: | 5003318007 |
| Jacket number: | 0426683 |
| Holds for other agencies: | No |
| Facility: | OWN RECOGNIZANCE |
| Arresting agency: | 01-PBSO |
| Booking number: | 2011048501 |
| Booking date: | Oct 25, 2011 |
| Release date: | Oct 25, 2011 |
| Booking location: | Palm Beach County, FL |
| Description: | FRAUD - OBTAIN CONTROLLED SUBSTANCE BY |
| Charge number: | 893.13-3735 |
| Bond amount: | $0 |