License Number
011659656
County ID
56
Email
P O BOX 33038
Owner Name
SHIVTISHA 21143 LLC
Owner ID
111203
Vendor Name
LAKESIDE MARKET AND GRILL
Vendor ID
116596
Address
21143 U S HWY 431
WEDOWEE, AL 36278
United States
License Type 1
040
License Type 2
060
License Type 3
990