Name |
Theodore Roosevelt Provost |
Sex |
male |
Birth Date |
October 10, 1905 |
Death Date |
April 27, 1982 |
Age at Death |
76 years, 6 months, 17 days old |
Birth Place |
Louisiana |
Death Place |
San Francisco County, California |
Mother's Maiden Name |
Ellis |
Social Security Number |
546-06-4522 |