| Hair: | Black |
| Eyes: | Brown |
| SO#: | P00406956 |
| Arresting agency: | Doctor Visit (added for converted Tiburon data only |
| Booking number: | 1134634 |
| Booking date: | Oct 6, 2011 |
| Release date: | Dec 21, 2011 |
| Booking location: | Fulton County, GA |
| Charge: | U/S SBPP EF-452371 |
| Bond type: | $0 Other |