| Name | Theodore Milton Mehlberg |
|---|---|
| Sex | male |
| Birth Date | May 9, 1928 |
| Death Date | February 24, 1997 |
| Age at Death | 68 years, 9 months, 15 days old |
| Birth Place | Iowa |
| Death Place | Los Angeles County, California |
| Mother's Maiden Name | Kummerfeld |
| Social Security Number | 555-36-7496 |