BISMARCK, N.D. (AP) — Patients can now apply for state medical marijuana cards in North Dakota,  two years after voters approved the drug.
Applications also opened for designated caregivers, or people who help patients, such as a family member or friend. Both patients and caregivers must pay a $50 annual fee and meet certain requirements, including doctor or registered nurse certification for patients and a criminal background check for caregivers.

The Health Department expects to begin issuing registry cards in December, around the time a marijuana manufacturing facility in Bismarck anticipates having product available.

The state estimates that as many as 4,000 people will legally be using the drug three years from now. That’s based on the experience in Delaware, which North Dakota officials have cited as a model.

“One of the major milestones in implementing the medical marijuana program has now been accomplished,” said Jason Wahl, director of the department’s Medical Marijuana Division.

North Dakota voters approved the drug in November 2016 , and lawmakers crafted a law in 2017 that allows its use for 17 medical conditions, along with terminal illnesses.

The Health Department has endured some criticism over the amount of time it is taking to make the drug available, though the timeline isn’t unusual when compared to other states with the drug, according to the advocacy group Americans for Safe Access.

North Dakota has used a phased-in approach modeled after other states that have set up medical marijuana programs.

The state earlier this year selected companies to implement a monitoring system and to perform laboratory testing . It recently named companies to open dispensaries in Fargo and Bismarck , the state’s two largest cities, and expects to select companies by late November to open dispensaries in Grand Forks and Williston. Applications are to open in January for dispensaries in Devils Lake, Dickinson, Jamestown and Minot. All eight dispensaries are expected to be operating by next July.