This Autographed Horizontal 11x14 Photo has been Personally Signed by Noah Wyle of E.R.. This item is 100% Authentic and comes with a PSA/DNA Certification numbered Hologram. Please note that PSA/DNA no longer provides serial-numbered COA cards, and the attached PSA/DNA sticker will serve as the complete authentication for this item. The authenticity can be verified on Professional Sports Authenticators website.