Name | Juan Diego Provencher |
---|---|
Sex | male |
Birth Date | January 19, 1957 |
Death Date | January 30, 1990 |
Age at Death | 33 years, 11 days old |
Birth Place | Other Country |
Death Place | San Mateo County, California |
Father's Last Name | Delgado |
Mother's Maiden Name | Provencher |
Social Security Number | 564-15-1658 |