VWDC :: Licensee Registration

Register a Licensee

Licensee Information

Operation Name

ABC License #

Tax Number

License Type

Address 1

Address 2

City

County

Zip Code

Phone Number

Fax Number

Toll Free Number

Web Site

Primary Contact Information

First Name

Last Name

Email Address

Phone Number

Fax Number

Cell Number

I affirm to the truth of the information contained above, pursuant to the Alcohol Beverage Control Act and regulations of the Virginia ABC Board and the VWDC Operating Rules and Agreement.

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