| Date of birth: | Sep 10, 1930 |
| Obts number: | 5003366481 |
| Jacket number: | 0459013 |
| Holds for other agencies: | No |
| Facility: | SURETY BOND |
| Arresting agency: | 01-PBSO |
| Booking number: | 2014029214 |
| Booking date: | Jul 17, 2014 |
| Release date: | Jul 17, 2014 |
| Booking location: | Palm Beach County, FL |
| Statute: | 831.311-6284 |
| Charge: | FRAUD - SELL POSS MFG ALTER DOH PRESCRIPTION BLANKS |
| Bond amount: | $3,000 |
