| Hair: | Unknown or bald |
| Eyes: | Unknown |
| SO#: | 42453 |
| Arresting agency: | Department of Public Safety |
| Booking number: | 87417 |
| Booking date: | Oct 12, 2004 |
| Release date: | Oct 12, 2004 |
| Jail name: | Angelina County Jail |
| Location: | 2311 E Lufkin Ave, Lufkin, TX 75901 |
| Warrant id: | 04-23358 |
| Charge: | FRAUD DEL CS/PRESCRIPTION SCH III/IV/V |
| Issuing auth: | ANG |
| Offense date: | Apr 1, 2004 |
| Bond type: | $1,000 - Bail/Attorney Bond |
| Charge desposition: | Posted Bond |