The Pennsylvania Department of Health on Thursday announced the names of 27 companies that will be permitted to sell medical marijuana across the state next year, reaching another milestone in a program that could lead to cannabis being available by 2018.

The announcement also set off another round of consternation about whether the cannabis dispensaries were being distributed fairly and put in places where they would serve the most patients.

In suburban Philadelphia, six are to open in Montgomery County, three in Bucks County, and two each in Chester and Delaware Counties.

In Philadelphia. the state approved four locations, three across the northernmost tier of the city, with one in East Mount Airy and two in Northeast Philadelphia. The fourth is in Fishtown near the SugarHouse Casino.

"There's not one in Center City, not one in West Philadelphia, not one by the airport, or in Old City," said Andrew B. Sacks, a lawyer and chairman of the medical marijuana and hemp department at Sacks, Weston, Diamond LLC. "There should have been one on Walnut Street. Period. This is just asinine."

Each of the 27 winners has the right to operate three storefronts. Though 81 dispensaries are allowed by law, many applicants chose not to ask for additional outlets.

Just 52 are expected to open sometime next year.

"It's hard to see if there was much consideration for access by patients, given these locations," said Alva Mather, one of three partners at the Pepper Hamilton LLP law firm leading a new cannabis industry group. "Being able to get to health-care facilities is always an issue. It's not set up with that framework in mind."

"A lot of these patients are terminal," said Chris Goldstein, a marijuana and patient advocate who writes the Philly420 column for Philly.com. "Dispensaries should be as convenient as a CVS or a Rite Aid."

But that could change.

The winners who have not committed themselves to opening all three of their allotted dispensaries "have the ability to put in for their second or third locations after their first is up and running," said April Hutcheson, a spokeswoman for the state Health Department.

Hutcheson said the locations were businesses that scored the highest on their applications.

"This is only the start of the program, and we're moving quickly to getting medication to the public," Hutcheson said. "As we need to grow, we can. They still have the ability to open up more locations."

The city zoning office is ready to expand the number of sites. It has cleared the way for 10 dispensary locations, granting zoning permits for real estate in neighborhoods that include Northern Liberties, Old City, and Center City. There is a variance for 12th and Walnut Streets. It is up to a permit winner to arrange with the building owner to open at one of those sites.

All applicants were required to pay $5,000 to apply for a dispensary permit. The companies also had to post a $30,000 deposit — refundable only to failed bidders — for each storefront. Each of the winners' three shops is required to be in a different county.

Dispensaries will operate like pharmacies that sell only one product: medicinal cannabis oils, which can be vaporized or consumed in a solution. They will be forbidden to sell whole-plant, flower, or edible products. Each permit, according to industry experts, is worth $10 million to $20 million, depending on the location and the number of customers each serves.

The dispensaries will be the only point where patients will encounter medical marijuana. To get it, they will be required to see a doctor who is certified and registered with the state Department of Health. The doctor will write a letter stating that the patient suffers from one or more of 17 qualifying conditions. It is up to the patient to submit the letter to the state and receive an ID card. Only card holders will be allowed to enter, and they will be able to buy medical cannabis from any dispensary in the state.

In Southeastern Pennsylvania, dispensaries are slated for Abington, Bensalem, Bristol, Devon, Elkins Park, Fort Washington, King of Prussia, Phoenixville, Plymouth Meeting, Philadelphia (4), Sellersville, Upper Darby, West Norriton,  and Yeadon,

Last week, the state announced the winners of 12 permits to grow legal cannabis in the state and process it into medicine.

Though industry experts have called the Health Department's efforts cautious and fair, many losing applicants have called the process opaque and biased. They have until Friday to file appeals. Several have threatened lawsuits. Litigation filed by failed applicants in Maryland and Florida has stalled the introduction of medical marijuana programs in those states for years.

The Health Department on Wednesday said it remained on track to provide cannabis oil to patients in 2018.