I took it to the downtown Portland offices, gave my signed medicals from the doctor and paid my fee. The lady behind the glass stamped it and said I was safe to use/grow with the stamped doc's and that my actual length of prescription wouldn't start until I physically received the card.
I've started to grow already and am nearing my first harvest (using automatics for a 70 day crop). Things are looking up but I would sure feel better if I had the actual card in hand.